Memantine Memantine is a nonselective NMDA receptor
antagonist that is reported to have antidepressant actions in rodent models64,67; there are no data on the effects of memantine on mTORC1 signaling or synapse formation. Memantine is approved for use in humans (ie, Alzheimer’s disease) for which it has modest effects.68 Although there have also been clinical studies of memantine in depressed patients, the results have not been promising. In a double-blind, placebo-controlled study, memantine was found to have no significant antidepressant effect in MDD patients.7 The reasons for the lack of response are unclear, but could be related to the dose of memantine, or Inhibitors,research,lifescience,medical the route and time course of administration. For example, memantine was administered orally at an escalating dose over several weeks; it would be interesting Inhibitors,research,lifescience,medical to determine if intravenous dosing, similar to that for ketamine, would be more efficacious and rapid, ft is also notable that memantine is a low-affinity open-channel antagonist that is trapped at a lower rate (70%) compared with ketamine.64 AZD6765 Another nonselective NMDA antagonist that has been
tested as an antidepressant is AZD6765. This compound is reported to have antidepressant actions in rodent models.69 Moreover, AZD6765 has a reasonable safety profile Inhibitors,research,lifescience,medical in humans and does not induce psychotomimetic side effects. This compound was developed as a neuroprotective agent for the treatment of stroke, but lack of efficacy halted further development. However, Inhibitors,research,lifescience,medical a recent clinical study demonstrates that AZD6765 produces a rapid antidepressant response in depressed
patients.69 fn this study, which was conducted with patients considered treatment-resistant (ie, based on their lack of response to typical antidepressants), approximately one third showed a rapid and significant antidepressant response within 80 minutes Inhibitors,research,lifescience,medical of a single treatment. A recent study has reported that repeated dosing of AZD6765 (3 times a week for 3 weeks) produces an antidepressant response after 1 to 2 weeks of treatment.70 The only side effects reported were mild, transient dizziness and headaches. This relatively mild side-effect profile, particularly with regard to psychotomimetic and dissociative effects, could be related to the low proportion of AZD6765 that is trapped in the pore (54%) relative to ketamine (82 %).69 Together, these studies indicate that AZD6765 has a relatively rapid onset of action, with fewer side effects than ketamine. only Selleck BLZ945 GLYX-13 GLYX-13 is a tetrapeptide that acts as a partial agonist at the glycine site of the NMDA receptor complex, making this agent unique among the drugs acting at NMDA receptors that are being investigated for antidepressant activity. Originally designed to enhance learning and memory, subsequent studies have demonstrated that GLYX-13 produces rapid antidepressant actions in rodent models and in depressed patients.