Ketamine: Neuroprotective or Neurotoxic?

Divya Choudhury, Anita E. Autry, Kimberley F. Tolias, Vaishnav Krishnan

Research output: Contribution to journalReview articlepeer-review

Abstract

Ketamine, a non-competitive N-methyl-D-aspartate receptor (NMDAR) antagonist, has been employed clinically as an intravenous anesthetic since the 1970s. More recently, ketamine has received attention for its rapid antidepressant effects and is actively being explored as a treatment for a wide range of neuropsychiatric syndromes. In model systems, ketamine appears to display a combination of neurotoxic and neuroprotective properties that are context dependent. At anesthetic doses applied during neurodevelopmental windows, ketamine contributes to inflammation, autophagy, apoptosis, and enhances levels of reactive oxygen species. At the same time, subanesthetic dose ketamine is a powerful activator of multiple parallel neurotrophic signaling cascades with neuroprotective actions that are not always NMDAR-dependent. Here, we summarize results from an array of preclinical studies that highlight a complex landscape of intracellular signaling pathways modulated by ketamine and juxtapose the somewhat contrasting neuroprotective and neurotoxic features of this drug.

Original languageEnglish (US)
Article number672526
JournalFrontiers in Neuroscience
Volume15
DOIs
StatePublished - Sep 10 2021

Keywords

  • AMPA receptor
  • antidepressant
  • BDNF
  • ketamine mechanism
  • ketamine-induced neurotoxicity
  • neuroprotection
  • NMDA receptor

ASJC Scopus subject areas

  • Neuroscience(all)

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