TY  - JOUR
PY  - 2015//
TI  - Treatment-resistant major depression: rationale for NMDA receptors as targets and nitrous oxide as therapy
JO  - Frontiers in psychiatry
A1  - Zorumski, Charles F.
A1  - Nagele, Peter
A1  - Mennerick, Steven
A1  - Conway, Charles R.
SP  - 172
EP  - 172
VL  - 6
IS  - 
N2  - Major depressive disorder (MDD) remains a huge personal and societal encumbrance. Particularly burdensome is a virulent subtype of MDD, treatment resistant major depression (TMRD), which afflicts 15-30% of MDD patients. There has been recent interest in N-methyl-d-aspartate receptors (NMDARs) as targets for treatment of MDD and perhaps TMRD. To date, most pre-clinical and clinical studies have focused on ketamine, although psychotomimetic and other side effects may limit ketamine's utility. These considerations prompted a recent promising pilot clinical trial of nitrous oxide, an NMDAR antagonist that acts through a mechanism distinct from that of ketamine, in patients with severe TRMD. In this paper, we review the clinical picture of TRMD as a subtype of MDD, the evolution of ketamine as a fast-acting antidepressant, and clinical and basic science studies supporting the possible use of nitrous oxide as a rapid antidepressant.<p />  <p>Language: en</p>
LA  - en
SN  - 1664-0640
UR  - http://dx.doi.org/10.3389/fpsyt.2015.00172
ID  - ref1
ER  -