Role of mTOR1 signaling in the antidepressant effects of ketamine and the potential of mTORC1 activators as novel antidepressants

Neuropharmacology. 2023 Feb 1:223:109325. doi: 10.1016/j.neuropharm.2022.109325. Epub 2022 Nov 9.

Abstract

Conventional antidepressant medications act on monoaminergic systems and have important limitations, including a therapeutic delay of weeks to months and low rates of efficacy. Recently, clinical findings have indicated that ketamine, a dissociative anesthetic that blocks N-methyl-d-aspartate receptor channel activity, causes rapid and long-lasting antidepressant effects. Although the exact mechanisms underlying the antidepressant effects of ketamine are not fully known, preclinical studies have demonstrated a key role for mechanistic target of rapamycin complex 1 (mTORC1) signaling and a subsequent increase in synapse formation in the medial prefrontal cortex. In this review, we discuss the role of mTORC1 and its subsequent signaling cascade in the antidepressant effects of ketamine and other compounds with glutamatergic mechanisms of action. We also present the possibility that mTORC1 signaling itself is a drug discovery target.

Keywords: Antidepressants; Glutamatergic signaling; Ketamine; Major depressive disorder; mTOR; mTORC1.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / pharmacology
  • Antidepressive Agents / therapeutic use
  • Depression / drug therapy
  • Ketamine* / pharmacology
  • Ketamine* / therapeutic use
  • Mechanistic Target of Rapamycin Complex 1 / metabolism
  • Receptors, N-Methyl-D-Aspartate / metabolism
  • Signal Transduction

Substances

  • Ketamine
  • Mechanistic Target of Rapamycin Complex 1
  • Antidepressive Agents
  • Receptors, N-Methyl-D-Aspartate