Indeed, direct infusion of BDNF into the hippocampus, or even peripheral administration of BDNF, produces antidepressant behavioral responses.27,58 However, the development of small molecular BDNF agonists has been extremely difficult and has met with little success. There have been reports of agents that act via BDNF-tropomyosin receptor kinase B (TrkB) signaling, although the ability of these
agents to directly stimulate Inhibitors,research,lifescience,medical TrkB receptors is still in question. In addition, BDNF is known to cause depressive behaviors when infused or expressed in the mesolimbic dopamine system,4,59 raising some questions about systemic administration of a direct acting agonist. However, we have found that peripheral administration of recombinant BDNF increases signaling in the brain and produces antidepressant actions in rodent Inhibitors,research,lifescience,medical models, indicating that an antidepressant response is the predominant effect of systemic administration.60 Novel NMDA receptor antagonists for the EPZ-6438 cost treatment of depression: new concepts for development of glutamatergic agents The exciting studies of ketamine and the potential for development of an entirely new class of Inhibitors,research,lifescience,medical antidepressants
with a novel mechanism and rapid, efficacious onset of action have motivated the field to identify additional NMDA receptor agents. Listed below are a few of the most promising agents under development. In addition, studies of ketamine demonstrate a different conceptual framework for pharmacological actions in the treatment of depression: namely a drug with rapid, but transient
acute actions on glutamate, which is critical to avoid excitotoxic damage, followed within a few hours Inhibitors,research,lifescience,medical by a Inhibitors,research,lifescience,medical therapeutic antidepressant response. Importantly, ketamine also produces a relatively long-lasting synaptogenic and antidepressant behavioral response. This differs from current drug development approaches to produce high-affinity agents that engage and occupy the target-binding site for extended time periods. This possibility is supported isothipendyl by anecdotal evidence using low doses of ketamine and bolus vs slow infusions.61 Although the prevailing theory holds that the therapeutic response occurs via blockade of NMDA receptors, it is also known that ketamine acts at other neurotransmitter receptors and ion channels. This includes blockade of dopamine D2 receptors62 and cholinergic nicotinic receptors.63 These findings raise the possibility that the actions of ketamine occur through disruption of multiple neurotransmitter systems. It is also possible that disruption of these other receptors could contribute to the side effects of ketamine. These possibilities will require further investigation, including studies of more selective NMDA receptor antagonists as described below.