Which medications in the drug class NMDA Antagonists are used in the treatment of Depression?

Updated: Aug 06, 2020
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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NMDA Antagonists

Studies have shown that the N-methyl-D-aspartate (NMDA) receptor may play a role in the pathophysiology of psychiatric disorders, including depression. The use of NMDA receptor antagonists have been shown to be effective in the treatment of major depressive disorder.

Esketamine intranasal (Spravato)

Esketamine, the S-enantiomer of racemic ketamine, is a nonselective, noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist (NMDA is an ionotropic glutamate receptor). The mechanism by which esketamine exerts its antidepressant effect is unknown. It is indicated for treatment-resistant depression in conjunction with an oral antidepressant. It is also indicated for depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior with an oral antidepressant.

Ketamine (Ketalar)

A non-competitive NMDA antagonist that blocks glutamate and has been found to have antidepressant effects. Used off-label to treat treatment-resistant depression. By acting on the cortex and the limbic system, produces a cataleptic-like effect state, which in turn causes the patient to feel dissociated from the surrounding environment.

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