A brief summary of the specific types of monoaminergic antidepressants will follow as it is important to note previous treatments of depression. Tricyclic antidepressants manipulate serotonin, and norepinephrine pathways through reuptake inhibition. These antidepressants are characterized by low levels of tolerability, and are rarely prescribed. Monoamine oxidase a inhibitors (MAOIs) increase synaptic monoamine availability. The issues of MAOIs arose from the avoidance of food with high levels of tryptophan/tyrosine because a possible potential for hypertensive crises, or, a sudden surge of serotonin, and impaired synaptic processing. SSRIs, or selective serotonin reuptake inhibitors cause excess …show more content…
It is currently valued for its pain management properties because it produces angalesia; ketamine also binds to opioid mu and sigma receptors. In a randomized controlled trial of a single infusion of ketamine compared to an active placebo, midazolam involving patients with treatment resistant major depression, done by Murrough, Iosifescu, Chang, et al. (2013), found that twenty-four hours after the drug administration that ketamine demonstrated rapid antidepressant effects that further supported the NDMA receptor regulation as a supportive mechanism for expedited alleviation, and improvement in severe forms of depression. Consistent with this outcome, the effects were maintained for several days beyond the twenty-four hour marker which is an important benefit. To further prove the rapid effects of ketamine in trial studies, Valentine et al. (2011) conducted a study in 10 patients with major depression, who were all given a single does of saline, and then a single does of ketamine in a fixed order, one week apart under a single-blind condition. Participants noted a significant improvement in depression after 1,2,3,5 hours, and 7 days later for ketamine compared to saline. Lastly, Ibrahim et al. (2011) investigated the effects of a single IV does of ketamine in an open label study of forty patients who suffer form TRD, …show more content…
A randomized, double-blind study of eighteen patients with treatment-resistant bipolar depression, Diazgrenados et al. (2010) treated these patients with an IV infusion of ketamine or saline two separate days, two weeks apart. He found that within forty minutes of administration, depressive symptoms were significantly improved for ketamine compared to saline, and that these improvements lasted through the third day, but began to die down around day ten. This study suggest that the advantageous effects of ketamine were effective in these TRD patients, however the effect was not sustained over a significant amount of time, but was more significant than traditional