Esketamine: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
 
(One intermediate revision by the same user not shown)
Line 6: Line 6:
| image = 800px-S-ketamine-3D-balls.png
| image = 800px-S-ketamine-3D-balls.png
| width = 180
| width = 180
| image2 = S-ketamine-3D-balls.png
| image2 =Esketamine2DCSD.png
| drug_name = Esketamine
| drug_name = Esketamine



Latest revision as of 15:47, 8 April 2015

Esketamine
Clinical data
Trade namesKetanest S
AHFS/Drugs.comConsumer Drug Information
ATC code
Identifiers
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
ChEBI
ChEMBL
E number{{#property:P628}}
ECHA InfoCard{{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value).
Chemical and physical data
FormulaC13H16ClNO
Molar mass237.725 g/mol
3D model (JSmol)
 ☒N☑Y (what is this?)  (verify)

WikiDoc Resources for Esketamine

Articles

Most recent articles on Esketamine

Most cited articles on Esketamine

Review articles on Esketamine

Articles on Esketamine in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Esketamine

Images of Esketamine

Photos of Esketamine

Podcasts & MP3s on Esketamine

Videos on Esketamine

Evidence Based Medicine

Cochrane Collaboration on Esketamine

Bandolier on Esketamine

TRIP on Esketamine

Clinical Trials

Ongoing Trials on Esketamine at Clinical Trials.gov

Trial results on Esketamine

Clinical Trials on Esketamine at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Esketamine

NICE Guidance on Esketamine

NHS PRODIGY Guidance

FDA on Esketamine

CDC on Esketamine

Books

Books on Esketamine

News

Esketamine in the news

Be alerted to news on Esketamine

News trends on Esketamine

Commentary

Blogs on Esketamine

Definitions

Definitions of Esketamine

Patient Resources / Community

Patient resources on Esketamine

Discussion groups on Esketamine

Patient Handouts on Esketamine

Directions to Hospitals Treating Esketamine

Risk calculators and risk factors for Esketamine

Healthcare Provider Resources

Symptoms of Esketamine

Causes & Risk Factors for Esketamine

Diagnostic studies for Esketamine

Treatment of Esketamine

Continuing Medical Education (CME)

CME Programs on Esketamine

International

Esketamine en Espanol

Esketamine en Francais

Business

Esketamine in the Marketplace

Patents on Esketamine

Experimental / Informatics

List of terms related to Esketamine

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Esketamine (also (S)-ketamine or S(+)-ketamine) (brand name Ketanest S) is a general anaesthetic and a dissociative. It is the S(+) enantiomer of the drug ketamine, a general anaesthetic. Esketamine acts primarily as a non-competitive NMDA receptor antagonist, but is also a dopamine reuptake inhibitor. As of July 2014, it is in phase II clinical trials for treatment-resistant depression (TRD).[1]

Pharmacology

Esketamine is approximately twice as potent as racemic ketamine.[2] It is eliminated from the human body more quickly than R(−)-ketamine or racemic ketamine, although R(−)-ketamine slows its elimination.[3]

A number of studies have suggested that esketamine has a more medically useful pharmacological action than R(−)-ketamine or racemic ketamine. Esketamine inhibits dopamine transporters eight times more than R(−)-ketamine.[4] This increases dopamine activity in the brain. At doses causing the same intensity of effects, esketamine is generally considered to be more pleasant by patients.[5][6] Patients also generally recover mental function more quickly after being treated with pure esketamine, which may be a result of the fact that it is cleared from their system more quickly.[2][7]

Esketamine has an affinity for the PCP binding site of the NMDA receptor 3-4 times higher than that of R(−)-ketamine. Unlike R(−)-ketamine, esketamine does not bind significantly to sigma receptors. Esketamine increases glucose metabolism in frontal cortex, while R(−)-ketamine decreases glucose metabolism in the brain. This difference may be responsible for the fact that esketamine generally has a more dissociative or hallucinogenic effect while R(−)-ketamine is reportedly more relaxing.[7] However, other studies have found no difference between the isomers in the patient's level of vigilance.[5]

Potential use as an antidepressant

Johnson & Johnson is developing a nasal spray formulation of esketamine as a treatment for depression in patients that have been unresponsive to other antidepressants in the United States.[1] As of July 2014, phase II clinical trials of intranasal esketamine sponsored by the Johnson & Johnson subsidiary Janssen Pharmaceutica are underway.[1][8] Other pharmaceutical companies are also developing new antidepressant drugs that act similarly to ketamine, including Naurex's rapastinel (GLYX-13) and NRX-1074, and Cerecor's CERC-301.[1]

Although most studies suggest that esketamine is preferable for medical uses, a 2013 study found that the antidepressant effect of R(−)-ketamine lasted longer than those of S(+)-ketamine in mice.[9]


References

  1. 1.0 1.1 1.2 1.3 Wijesinghe, R (2014). "Emerging Therapies for Treatment Resistant Depression". Ment Health Clin. 4 (5): 56. ISSN 2168-9709.
  2. 2.0 2.1 PMID 9893910 (PMID 9893910)
    Citation will be completed automatically in a few minutes. Jump the queue or expand by hand
  3. PMID 11719729 (PMID 11719729)
    Citation will be completed automatically in a few minutes. Jump the queue or expand by hand
  4. PMID 10553955 (PMID 10553955)
    Citation will be completed automatically in a few minutes. Jump the queue or expand by hand
  5. 5.0 5.1 PMID 1443509 (PMID 1443509)
    Citation will be completed automatically in a few minutes. Jump the queue or expand by hand
  6. PMID 7840417 (PMID 7840417)
    Citation will be completed automatically in a few minutes. Jump the queue or expand by hand
  7. 7.0 7.1 PMID 9088882 (PMID 9088882)
    Citation will be completed automatically in a few minutes. Jump the queue or expand by hand
  8. http://clinicaltrials.gov/show/NCT01998958
  9. PMID 24316345 (PMID 24316345)
    Citation will be completed automatically in a few minutes. Jump the queue or expand by hand


Template:General anesthetics

Template:Antidepressants