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  • Essay / Ketamine as a prototype for the next generation of antidepressants

    Depression is the most common mental disorder worldwide and one of the ten leading causes of morbidity and mortality (Berton and Nestler, 2006; Nestler and al., 2002). 20% of the world's population is affected by depression at any time in their life, while 4% of men and 8% of women are affected by clinically significant depressive disorder. However, depressive symptoms in general are much more common (Lehtinen, V and Joukamaa, M 1994). While depression comes second on the list of the most disabling disorders when measured by the number of years lived with disability, the WHO has predicted that it will become the number one major health problem in the Next 20 years. (Léonard BE and Cryan JF). Unfortunately, currently available antidepressants take weeks or even months to start working. However, the percentage of responders during this period varies from 30 to 60% (Trivedi et al, ref. 2006). More recently, ketamine has shown rapid and sustained antidepressant activity, a turning point that may revolutionize antidepressant therapeutic strategies and their outcomes. This article will evaluate the effectiveness of ketamine compared to standard antidepressants and highlight the potential of ketamine as a prototype for a new generation of fast-acting antidepressants. In the early 20th century, therapeutic strategies for depression ranged from invasive therapies such as insulin coma, to chemical and electrical shock therapy. to the administration of certain addictive chemicals such as chloral hydrate, barbiturates, amphetamines and opiates (Lopez-Munoz & Alamo C, 2009). In the 1950s, ipronizide, which had previously been used as an anti-tuberculosis drug, was introduced as the first mono-amino oxidase inhibitor (MAOI) and the first antidepressant ever marketed. Next, imipramine was middle of paper......elevated maze and social interaction test in Wistar rats. Depress Anxiety 5(1), pp 29−33.Simon GE, Savarino J, Operkalski B, Wang PS, (2006), Suicide risk during antidepressant treatment. ,Am. J. Psychiatry.,163, pp 41-47.Trivedi MH, (2006), Outcome evaluation of citalopram for depression using measures-based care in STAR*D implications for clinical practice. AmJ Psychiatry, 163(1): pp 28-40Liu and Aghanian 2008Zarate CA, Du J., Quiroz J., Gray NA, Denicoff K., Singh JB, et al. (2003). Regulation of cellular plasticity cascades in the pathophysiology and treatment of mood disorders: role of the glutamatergic system. Ann NY Acad Sci 1003, 273−291.Zarate C, Singh J, Manji HK (2006) Cellular plasticity cascades: targets for the development of new treatments for bipolar disorder. , Biol. Psych. 59, pages 1006-1020.