Metabolomic biomarkers for (R, S)-ketamine and (S)-ketamine in treatment-resistant depression and healthy controls: A systematic review.

Autor: Kumar R; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA., Nuñez NA; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA., Joshi N; Manipal Academy of Higher Education (MAHE), Manipal, India., Joseph B; Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA., Verde A; Section of Pediatrics, Department of Translational Medical Science, Federico II University, Naples, Italy.; Division of Medical Genetics, University of Utah, Salt Lake City, Utah, USA., Seshadri A; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA., Cuellar Barboza AB; Department of Psychiatry, Universidad Autónoma de Nuevo León, Monterrey, Mexico., Prokop LJ; Mayo Medical Libraries, Mayo Clinic College of Medicine, Rochester, Minnesota, USA., Medeiros GC; Department of Psychiatry & Behavioral Sciences, John Hopkins University School of Medicine, Baltimore, Maryland, USA.; Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA., Singh B; Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA.
Jazyk: angličtina
Zdroj: Bipolar disorders [Bipolar Disord] 2024 Jun; Vol. 26 (4), pp. 321-330. Date of Electronic Publication: 2024 Feb 07.
DOI: 10.1111/bdi.13412
Abstrakt: Background: Ketamine is increasingly used for treatment-resistant depression (TRD) while its mechanism of action is still being investigated. In this systematic review, we appraise the current evidence of metabolomic biomarkers for racemic ketamine and esketamine in patients with TRD and healthy controls (HCs).
Methods: A comprehensive search of several databases (Ovid MEDLINE®, Embase, and Epub Ahead of Print) was performed from each database's inception to June 29, 2022, in any language, was conducted. We included studies wherein the metabolomic biomarkers for racemic ketamine or esketamine were investigated in TRD or HCs. Our main outcomes were to examine changes in metabolites among patients treated with ketamine/esketamine and explore the association with response to ketamine/esketamine.
Results: A total of 1859 abstracts were screened of which 11 were included for full-text review. Of these, a total of five articles were included (N = 147), including three RCTs (n = 129) and two open-label trials (n = 18). All studies used racemic ketamine; one study additionally used esketamine. The included studies evaluated patients with treatment-resistant bipolar depression (n = 22), unipolar depression (n = 91), and HCs (n = 34). The included studies reported alteration in several metabolites including acylcarnitines, lipids, kynurenine (KYN), and arginine with ketamine in TRD. Studies suggest the involvement of energy metabolism, KYN, and arginine pathways. In HCs, acetylcarnitine decreased post-infusion, whereas inconsistent findings were observed after the ketamine infusion in TRD patients.
Conclusions: This systematic review provides preliminary evidence that ketamine may cause changes in several important pathways involved in energy metabolism and inflammation. Larger and more rigorous studies are needed.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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