The recent interest in the potential for ketamine as an antidepressant has led to speculation about the possible mechanisms that might underlie this effect. Although they do not permit the study of intracellular mechanisms, neuroimaging methods allow the study of biologically relevant changes in brain function and neurochemistry, which may help to elucidate the processes underlying the therapeutic benefit of ketamine in patients with depression. In this presentation, I will discuss current theories about the biological underpinnings of the antidepressant effects of ketamine. I will discuss the acute and subacute effects of ketamine on brain glutamate levels, as measured using proton magnetic resonance spectroscopy. I will also discuss ketamine effects on functional connectivity, blood flow and neuroreceptor binding, and consider how these might be related to its antidepressant properties.
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James Stone, Kings College London