Positive AMPA receptor modulation in the treatment of neuropsychiatric disorders: A long and winding road

Drug Discov Today. 2021 Dec;26(12):2816-2838. doi: 10.1016/j.drudis.2021.07.027. Epub 2021 Aug 3.

Abstract

Glutamatergic transmission is widely implicated in neuropsychiatric disorders, and the discovery that ketamine elicits rapid-acting antidepressant effects by modulating α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) signaling has spurred a resurgence of interest in the field. This review explores agents in various stages of development for neuropsychiatric disorders that positively modulate AMPARs, both directly and indirectly. Despite promising preclinical research, few direct and indirect AMPAR positive modulators have progressed past early clinical development. Challenges such as low potency have created barriers to effective implementation. Nevertheless, the functional complexity of AMPARs sets them apart from other drug targets and allows for specificity in drug discovery. Additional effective treatments for neuropsychiatric disorders that work through positive AMPAR modulation may eventually be developed.

Keywords: AMPA; Ampakines; Depression; Glutamatergic modulators; Ketamine; mGluR modulators.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antidepressive Agents / pharmacology
  • Drug Development / methods*
  • Drug Discovery / methods
  • Humans
  • Ketamine / pharmacology
  • Mental Disorders / drug therapy*
  • Mental Disorders / physiopathology
  • Receptors, AMPA / drug effects*
  • Receptors, AMPA / metabolism

Substances

  • Antidepressive Agents
  • Receptors, AMPA
  • Ketamine