Glutamatergic modulators

What are glutamatergic modulators?

Glutamate receptor modulators, such as ketamine and memantine, have been suggested as potential treatments for bipolar disorder when there are sub-optimal responses to other pharmaceuticals. Currently approved treatments for bipolar depression (i.e. several mood stabilisers, antidepressants and antipsychotics) are thought to involve a number of different neurotransmitters such as serotonin, dopamine, and norepinephrine. There is emerging evidence that glutamatergic system dysfunction may also play an important role in the pathophysiology of bipolar depression, and that drugs targeting the NMDA (N-methyl-D-aspartate) glutamate receptor may have antidepressant effects.

What is the evidence for glutamatergic modulators?

Moderate to high quality evidence suggests no benefit of adjunctive memantine for depression or mania symptoms.

Only low quality evidence was found for adjunctive ketamine, with review authors suggesting it has the potential to have a rapid and transient antidepressant effect, although the efficacy of a single intravenous dose may be limited.

July 2020

Last updated at: 12:36 am, 6th July 2020
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