Ketamine exhibit antidepressant effect through regulating sleep-wake rhythm and synaptic homeostasis

A single infusion of ketamine has sustained antidepressant effects and significantly decreases the risk of suicide, and the effects can last up for 7-10 days, but the underlying mechanism is unclear. The mechanism was reviewed underlying the antidepressant effects of ketamine, and found that ketamine may exert its antidepressant effect by regulating sleep/wake cycle, synaptic pruning, molecular pathways, and neural circuits for treatment-refractory depression.Further studies are needed to investigate the genetic, molecular mechanisms underlying the sustained antidepressant effect of ketamine, and the associated imaging findings through in vivo imaging of animals and imaging genetics techniques, explore the optimal time for administration of ketamine, and then provide accurate scientific basis for enhancing its anti-depressant effect. Key words: Ketamine; Sustained antidepressant effect; Homer1a protein; Synaptic pruning; Brain network