Evidence map›Paper›PMID 36821406›Full record

Trial reportJournal of clinical psychopharmacology

κ-Opioid Receptor Plasma Levels Are Associated With Sex and Diagnosis of Major Depressive Disorder But Not Response to Ketamine.

Brandi Quintanilla, Gustavo C Medeiros, Dede Greenstein, Peixiong Yuan, Jenessa N Johnston, Lawrence T Park, Fernando S Goes, Todd D Gould, Carlos A Zarate

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of clinical psychopharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00088699 (Investigation of the Rapid), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00088699 phase1 / phase2completednot on this map

Investigation of the Rapid (Next Day) Antidepressant Effects of an NMDA Antagonist

TypeinterventionalSponsorNational Institute of Mental Health (NIMH)Ran2004 to 2017Enrolled67ConditionsDepression, Mood Disorders, Major DepresssionArmsKetamine, Placebo
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Is the antidepressant efficacy of ketamine and esketamine mediated via opioid mechanisms?European psychiatry : the journal of the Association of European Psychiatrists · 2026
    Pooled it
  2. Neuropeptidergic systems in psychiatric disorders.Frontiers in endocrinology · 2025
    Review
  3. Kappa-opioid receptor stimulation in the nucleus accumbens shell and ethanol drinking: Differential effects by rostro-caudal location and level of drinking.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Brandi QuintanillaFrom the Experimental Therapeutics and Pathophysiology Branch, NIMH-NIH.
Gustavo C MedeirosDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD.
Dede GreensteinFrom the Experimental Therapeutics and Pathophysiology Branch, NIMH-NIH.
Peixiong YuanFrom the Experimental Therapeutics and Pathophysiology Branch, NIMH-NIH.
Jenessa N Johnston
Lawrence T ParkFrom the Experimental Therapeutics and Pathophysiology Branch, NIMH-NIH.
Fernando S GoesDepartment of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD.
Todd D Gould
Carlos A ZarateFrom the Experimental Therapeutics and Pathophysiology Branch, NIMH-NIH.ORCID 0000-0003-4442-7412
Johns Hopkins University · USUniversity of Maryland, Baltimore · USUniversity of Victoria · CA

Funding

Glutamatergic Modulators for Rapid & Sustained Antidepressant EffectZIAMH002857 · NIMH · NATIONAL INSTITUTE OF MENTAL HEALTH · PI ZARATE, CARLOS · 2009 to 2025
$55.0M
Target validation of novel therapeutic agents in mood disordersZIAMH002927 · NIMH · NATIONAL INSTITUTE OF MENTAL HEALTH · PI ZARATE, CARLOS · 2010 to 2025
$37.1M
Intramural NIH HHS Z99 MH999999Intramural NIH HHS ZIA MH002857Intramural NIH HHS ZIA MH002927
6 · The paper itself

Abstract

backgroundPreclinical evidence indicates that the κ-opioid receptor (KOR)/dynorphin pathway is implicated in depressive-like behaviors. Ketamine is believed to partly exert its antidepressant effects by modulating the opioid system. This post hoc study examined the following research questions: (1) at baseline, were there differences in KOR or dynorphin plasma levels between individuals with major depressive disorder (MDD) and healthy volunteers (HVs) or between men and women? (2) in individuals with MDD, did KOR or dynorphin baseline plasma levels moderate ketamine's therapeutic effects or adverse effects? and (3) in individuals with MDD, were KOR or dynorphin plasma levels affected after treatment with ketamine compared with placebo?

methodsThirty-nine unmedicated individuals with MDD (23 women) and 25 HVs (16 women) received intravenous ketamine (0.5 mg/kg) and placebo in a randomized, crossover, double-blind trial. Blood was obtained from all participants at baseline and at 3 postinfusion time points (230 minutes, day 1, day 3). Linear mixed model regressions were used.

resultsAt baseline, participants with MDD had lower KOR plasma levels than HVs ( F1,60 = 13.16, P < 0.001), and women (MDD and HVs) had higher KOR plasma levels than men ( F1,60 = 4.98, P = 0.03). Diagnosis and sex had no significant effects on baseline dynorphin levels. Baseline KOR and dynorphin levels did not moderate ketamine's therapeutic or adverse effects. Compared with placebo, ketamine was not associated with postinfusion changes in KOR or dynorphin levels.

conclusionsIn humans, diagnosis of MDD and biological sex are involved with changes in components of the KOR/dynorphin pathway. Neither KOR nor dynorphin levels consistently moderated ketamine's therapeutic effects or adverse effects, nor were levels altered after ketamine infusion.

trial registrationNCT00088699 ( ClinicalTrials.gov ).

Indexed as

KetamineMajor Depressive DisorderAntidepressive AgentsDynorphinsFemaleHumansMaleReceptors, Opioid, kappaAntidepressive AgentsDynorphinsKetamineReceptors, Opioid, kappa

Identifiers

PMID36821406
PMCPMC9992159
OpenAlexW4321611497

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.