I have read some articles mostly in which (R)-ketamine was revealed as a safer antidepressant with more efficacy than (R, S)-ketamine and (S)-ketamine. Hence, my question is why FDA approved nasal spray of (S)-ketamine for treatment-resistant depression or major depression? Is there any superiority in consuming (S)-ketamine?
A recent article in Molecular Psychiatry reviews the effects of (R) and (S) ketamine and answers you question. https://www.nature.com/articles/s41380-021-01167-1
To my knowledge, there is no clinical data to back the claim that one of the isomers would have more robust antidepressant effects.
S-ketamine, instead or racemic, was likely pursued due to patent reasons.
Samuel Kohtala I am not sure about clinical studies. However, some preclinical research has recently been studied and confirms R-ketamine as safer with more efficacy enantiomer than S-ketamine.
I highly doubt there's a consensus even among preclinical scientists. And even if there was, these results are not very meaningful for any true clinical discussion. With new studies demonstrating the antidepressant-like effects of virtually anything in rodents, from vitamin C to baking soda, I must confess I've lost a lot of respect for preclinical drug research - and that is me talking about my own field of research.
- Badges
- Science topic
- Similar topics
- Chemistry
- Pharmacology
- Medical Pharmacology
- Clinical Pharmacology