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Re: Ketamine lifts depression via a metabolite:

Posted by Deahoidar on June 10, 2016, at 13:30:22

In reply to Re: Ketamine lifts depression via a metabolite: » TriedEveryMedication, posted by SLS on June 4, 2016, at 17:59:01

> > > BDNF production is increased by AMPA receptor activation.
> > >
> > > That HNK is active in models of depression is not new. What is new is the discovery that glutamate AMPA receptors were involved in its pharmacology. Of course, this is not the end of the story. Increases in BDNF production (brain-derived neurotrophic factor) is a common denominator in the results of many antidepressant substances when they are effective.
> > >
> > >
> > > - Scott
> >
> >
> > ampakines like Aniracetam activate AMPA... Would you expect them to be helpful for depression?
>
> I don't know enough about the 'racetams and AMPA receptor structure and function. However, if you can find evidence that these drugs increase BDNF, they might indeed be helpful for major depressive disorder.
>
> Levetiracetam (Keppra) is an interesting drug. It actually prevents BDNF release in response to the kindling process that induces seizures. Robert Post likened the induction of mania as a form of kindling, especially as mania is triggered more easily with each successive episode. Most importantly, levetiracetam has antidepressant properties as demonstrated by animal studies. It is almost as if levetiracetam acts as a true mood stabilizer in way similar to lithium.
>
>
> - Scott
>
Animal studies (as unpleasant as they often are) are useful, but they are not always good predictor of drug efficacy in humans.

I find its better to practice cautious optimism until there are some well-designed randomized, double-blind, placebo-controlled clinical trials with sufficient numbers of patients, that demonstrate significant efficacy.
Too many promising treatments that demonstrated significant response in open-label studies have been found to be futile when subjected to a double-blind place-controlled clinical trial. It's amazing what the placebo effect can do.


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