Role of nitric oxide signaling in the antidepressant mechanism of action of ketamine: A randomized controlled trial

J Psychopharmacol. 2021 Feb;35(2):124-127. doi: 10.1177/0269881120985147.

Abstract

Ketamine is an N-methyl-D-aspartate receptor antagonist with rapid antidepressant effects. Studies suggest that inhibition of nitric oxide synthesis plays a role in the mechanism of action of ketamine. This randomized, placebo-controlled study investigated whether co-administration of sodium nitroprusside, a nitric oxide donor, compared to placebo, would attenuate the antidepressant and dissociative effects of ketamine. Sixteen ketamine responders were randomized to a double-blind infusion of ketamine co-administered with placebo or sodium nitroprusside. Our findings show no difference between the two conditions suggesting that the nitric oxide pathway may not play a primary role in ketamine's antidepressant or dissociative effects. The study is registered at clinicaltrials.gov (NCT03102736).

Keywords: Depression; N-methyl-D-aspartate receptor; antidepressant; dissociation; glutamate; ketamine; nitric oxide; sodium nitroprusside.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use*
  • Depression / drug therapy*
  • Depression / metabolism
  • Double-Blind Method
  • Excitatory Amino Acid Antagonists / therapeutic use
  • Female
  • Humans
  • Ketamine / therapeutic use*
  • Male
  • Nitric Oxide / metabolism*
  • Nitric Oxide Donors / metabolism
  • Receptors, N-Methyl-D-Aspartate
  • Signal Transduction / drug effects*

Substances

  • Antidepressive Agents
  • Excitatory Amino Acid Antagonists
  • Nitric Oxide Donors
  • Receptors, N-Methyl-D-Aspartate
  • Nitric Oxide
  • Ketamine

Associated data

  • ClinicalTrials.gov/NCT03102736