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2013 ADAA Scientific Symposium

NEUROBIOLOGY OF STRESS, DEPRESSION, AND RAPID ACTING ANTIDEPRESSANTS: REMODELING SYNAPTIC CONNECTIONS

Ronald S. Duman Ph.D.

Corresponding Author

Laboratory of Molecular Psychiatry, Department of Psychiatry, Yale University School of Medicine, , New Haven Connecticut

Correspondence to: Dr. Ronald S. Duman, Laboratory of Molecular Psychiatry, Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, Connecticut 06508. E‐mail:

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First published: 10 March 2014
Cited by: 56

Abstract

Stress and depression are associated with atrophy and loss of neurons in limbic and cortical brain regions that could contribute to the symptoms of depression. Typical monoamine reuptake inhibitor antidepressants have only modest efficacy and require long‐term treatment, and are only weakly effective in blocking or reversing these structural changes caused by stress. Recent findings demonstrate that ketamine, an NMDA receptor antagonist, produces rapid antidepressant actions in difficult to treat depressed patients. In addition, preclinical studies demonstrate that ketamine rapidly increases synaptic connections in the prefrontal cortex by increasing glutamate signaling and activation of pathways that control the synthesis of synaptic proteins. Moreover, ketamine rapidly reverses the synaptic deficits caused by exposure to chronic stress in rodent models. Studies of the signaling mechanisms underlying the actions of ketamine have provided novel approaches and targets for new rapid acting antidepressants with decreased side effects, as well as a better understanding of the neurobiology of stress, depression, and treatment response.

Number of times cited: 56

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