Monitoring ketamine treatment response in a depressed patient via peripheral mammalian target of rapamycin activation.

摘要

To the Editor: Most clinically used antidepressants target monoaminergic reuptake mechanisms. However, a limited efficacy and a delayed onset combined with several side effects make the currently available antidepressants less than ideal drugs. Treatment resistance occurs in approximately 15%-20% of depressed patients (1). To improve antidepres-sant drug efficacy, one line of research has focused on the N-methyl-D-aspartic acid (NMDA) receptor and its pathway in order to manipulate glutamatergic neurotransmission. One important signaling event following NMDA receptor stimulation is mammalian target of rapamycin (mTOR) activation that results in the protein's phosphorylation on serine residues 2481 and 2448. The ensuing signaling cascades are important for the induction of neuroplasticity (2).