Identification

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Name
Esketamine
Accession Number
DB11823
Type
Small Molecule
Groups
Approved, Investigational
Description

Major depressive disorder (MDD) is a significant cause of disability worldwide and the most common illness preceding suicide 5, 3. On March 5, 2019, the nasal spray drug, esketamine, also known as Spravato (by Janssen Pharmaceuticals), was approved by the FDA for treatment-resistant major depression.

Esketamine is the s-enantiomer of Ketamine. Ketamine is a mixture of two enantiomers (mirror image molecules). This is the first time that the FDA has approved esketamine for any use. The FDA approved ketamine (Ketalar) in 1970 4.

Esketamine may prove to be a promising treatment for patients diagnosed with major depressive disorder who have not experienced an improvement in symptoms despite treatment with various medications and therapies. The intranasal route of administration for this drug allows for easy administration and a fast onset of action, which sets it apart from many other antidepressant agents that may take several weeks to take effect.

Structure
Thumb
Synonyms
  • (-)-Ketamine
  • (−)-ketamine
  • (S)-(−)-ketamine
  • (S)-2-(o-chlorophenyl)-2-(methylamino)cyclohexanone
  • (S)-ketamine
  • Esketamine
  • L-ketamine
  • S-(-)-Ketamine
  • S-ketamine
Product Ingredients
IngredientUNIICASInChI Key
Esketamine hydrochlorideL8P1H35P2Z33643-47-9VCMGMSHEPQENPE-ZOWNYOTGSA-N
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
SpravatoSolution28 mg/0.2mLNasalJanssen Pharmaceuticals Inc.2019-03-05Not applicableUs
Additional Data Available
  • Application Number
    Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code
    Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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International/Other Brands
Keta-S / Ketanest S / Ketaved
Categories
UNII
50LFG02TXD
CAS number
33643-46-8
Weight
Average: 237.73
Monoisotopic: 237.0920418
Chemical Formula
C13H16ClNO
InChI Key
YQEZLKZALYSWHR-ZDUSSCGKSA-N
InChI
InChI=1S/C13H16ClNO/c1-15-13(9-5-4-8-12(13)16)10-6-2-3-7-11(10)14/h2-3,6-7,15H,4-5,8-9H2,1H3/t13-/m0/s1
IUPAC Name
(2S)-2-(2-chlorophenyl)-2-(methylamino)cyclohexan-1-one
SMILES
CN[C@@]1(CCCCC1=O)C1=CC=CC=C1Cl

Pharmacology

Indication

This drug is indicated in conjunction with an oral antidepressant for the treatment of treatment-resistant depression (TRD) in adults Label.

Note: Esketamine is not approved as an anesthetic agent. The safety and effectiveness of esketamine as an anesthetic agent have not been established to this date Label.

Associated Conditions
Pharmacodynamics

General effects

Esketamine is considered a central nervous system (CNS) depressant agent. It may cause sedation, dizziness, and lethargy, among other symptoms Label. This drug has dissociative and antidepressant properties Label. Acutely, esketamine may impair attention, judgment, thinking, reaction speed, and motor skills. Two placebo-controlled studies were performed to evaluate the effects of ketamine on the ability to drive. The effects of esketamine 84 mg were comparable to placebo at 6 hours and 18 hours post ingestion Label.

Effects on cardiac electrophysiology

The effect of esketamine (84 mg nasal spray and 0.8 mg/kg esketamine intravenously infused over 40 minutes) on the QTc interval was studied in a randomized, double-blind, placebo-, and positive-controlled (moxifloxacin 400 mg), 4-period, crossover study in 60 healthy volunteers. A marked increase in heart rate (higher than 10 bpm) was measured in subjects receiving intranasal and intravenous esketamine. Summative evidence from both nonclinical and clinical data suggests a lack of clinically relevant QTc prolongation at the normal therapeutic dose of esketamine Label.

Effects on blood pressure

Eskestamine causes increases in systolic and/or diastolic blood pressure at all therapeutic doses. Peak blood pressure elevation after esketamine administration occurs about 40 minutes after administration and lasts approximately 4 hours Label.

Cognitive effects

In a study of healthy volunteers, one dose of this agent caused decline in cognitive performance 40 minutes after administration. Compared to subjects ingesting a placebo, esketamine-treated subjects required a higher level of effort to complete assigned cognitive tests at 40 minutes after administration. Cognitive performance and mental effort were found to be similar between esketamine and placebo at 2 hours after administration Label.

Reports of long-term memory or cognitive impairment have been made following repeated ketamine misuse or abuse. No adverse effects of esketamine nasal spray on cognitive function were seen in a one-year open-label safety study. The long-term cognitive effects of esketamine have not been studied for more than a 1 year period, therefore, the risk of cognitive decline with long-term use is not yet confirmed Label.

Mechanism of action

Esketamine, the S-enantiomer of racemic ketamine, is a non-selective, non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor, an ionotropic glutamate receptor. The exact mechanism by which esketamine acts as an antidepressant is unknown. The primary circulating metabolite of esketamine (noresketamine) shows activity at the same receptor with a weaker affinity Label.

TargetActionsOrganism
UNMDA receptor
antagonist
Humans
UGlutamate receptor ionotropic, NMDA 2B
antagonist
Humans
UElongation factor 2
inhibitor
Humans
UBrain-derived neurotrophic factor
agonist
Humans
UBDNF/NT-3 growth factors receptorNot AvailableHumans
Additional Data Available
Adverse Effects

Comprehensive structured data on known drug adverse effects with statistical prevalence. MedDRA and ICD10 ids are provided for adverse effect conditions and symptoms.

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Additional Data Available
Contraindications

Structured data covering drug contraindications. Each contraindication describes a scenario in which the drug is not to be used. Includes restrictions on co-administration, contraindicated populations, and more.

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Additional Data Available
Blackbox Warnings

Structured data representing warnings from the black box section of drug labels. These warnings cover important and dangerous risks, contraindications, or adverse effects.

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Absorption

Due to the fact that this drug is administered via nasal spray, absorption is rapid. The mean absolute bioavailability is approximately 48% after esketamine nasal spray administration. The time to achieve peak esketamine plasma concentration is 20 to 40 minutes after the last nasal spray of esketamine. Inter-subject variability of esketamine ranges from 27% to 66% for Cmax (maximum concentration) and 18% to 45% for AUC (area under the curve). The intra-subject variability of esketamine is about 15% for Cmax and 10% for AUC Label.

Volume of distribution

The average steady-state volume of distribution of esketamine administered by the intravenous route is 709 L Label.

Protein binding

The protein binding of esketamine is about 43% to 45% Label.

Metabolism

Esketamine is mainly metabolized to the noresketamine metabolite by cytochrome P450 (CYP) enzymes, CYP2B6 and CYP3A4, and to a lesser extent, CYP2C9 and CYP2C19. Noresketamine is metabolized by cytochrome-dependent metabolic pathways followed by subsequent glucuronidation of metabolites Label.

Route of elimination

Less than 1% of a dose of nasal esketamine is measured as unchanged drug, excreted in the urine. Following intravenous (IV) or oral (PO) administration, esketamine-derived metabolites were mainly recovered in urine (≥ 78% of a radiolabeled dose), and a smaller percentage was measured in the feces (≤ 2% of a radiolabeled dose) Label.

Half life

The mean terminal half-life (t1/2) ranges from 7 to 12 hours Label.

Clearance

The average clearance of esketamine is approximately 89 L/hour following intravenous administration Label.

Elimination of the major esketamine metabolite, noresketamine, from plasma is slower than esketamine. The decrease of noresketamine plasma concentrations occurs in a biphasic fashion, with a more rapid decline for the first 4 hours post-administration, and an average terminal t1/2 of approximately 8 hours Label.

Toxicity

Ketamine hydrochloride LD50: 447 mg/kg, Rat (oral) MSDS

Neurotoxicity

In a one-dose neuronal toxicity study with esketamine intranasal administration to adult female rats, no finding of neuronal vacuolation in the brain occurred with doses up to the equivalent of the maximum recommended human dose of 84 mg/day. In a second single dose neurotoxicity study performed with intranasal esketamine administration in adult female rats, no observation of neuronal necrosis up to a dose equivalent to the maximum recommended human dose was made. Neuronal vacuolation was not evaluated in this study Label. The relevance of these findings in humans is unknown at this time Label.

A note on dependence and tolerance

Reports of physical dependence have been made following prolonged use of ketamine. Withdrawal signs and symptoms after abrupt discontinuation or significant dosage reduction of a drug is a common manifestation of drug dependence. There were no withdrawal symptoms observed up to 4 weeks in subjects after stopping esketamine treatment. Withdrawal symptoms have been observed after the discontinuation of frequently used (more than weekly) high doses of ketamine for a longer duration. These symptoms of withdrawal have a higher chance of occurring if esketamine was similarly abused Label.

Symptoms of withdrawal reported to be associated with daily intake of high ketamine doses include craving, fatigue, poor appetite, and anxiety. Therefore, monitor esketamine-treated patients for symptoms and signs of physical dependence upon the discontinuation of the drug. Tolerance has been reported with prolonged use of ketamine. Tolerance is characterized by a decreased response to a drug following repeated doses (i.e., a higher dose of a drug is required to produce the same effect that was previously achieved at a lower dose). Comparable tolerance would be expected to occur with long-term use of esketamine Label.

Use in pregnancy

This drug may cause fetal harm, based on the findings of animal studies. Pregnancy planning and prevention in females of reproductive potential should occur before the initiation of esketamine treatment Label. There is a pregnancy registry for women who exposed to esketamine during pregnancy. The goal of the registry is to gather data about the health of women and infants exposed to esketamine.

Use in lactation

Esketamine is present in human milk. No safety data on the effects of esketamine on the breastfed infant or on milk production are available. Studies in young animals report neurotoxicity. Due to the risk of neurotoxicity, advise patients that breastfeeding is not recommended during treatment with this drug Label.

Affected organisms
Not Available
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
(R)-warfarinThe metabolism of (R)-warfarin can be increased when combined with Esketamine.
(S)-WarfarinThe metabolism of (S)-Warfarin can be increased when combined with Esketamine.
1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic AcidThe risk or severity of hypertension can be increased when Esketamine is combined with 1-(3-Mercapto-2-Methyl-Propionyl)-Pyrrolidine-2-Carboxylic Acid.
1-benzylimidazoleThe risk or severity of hypertension can be increased when Esketamine is combined with 1-benzylimidazole.
2,5-Dimethoxy-4-ethylamphetamineThe risk or severity of hypertension can be increased when Esketamine is combined with 2,5-Dimethoxy-4-ethylamphetamine.
2,5-Dimethoxy-4-ethylthioamphetamineThe risk or severity of hypertension can be increased when Esketamine is combined with 2,5-Dimethoxy-4-ethylthioamphetamine.
4-Bromo-2,5-dimethoxyamphetamineThe risk or severity of hypertension can be increased when Esketamine is combined with 4-Bromo-2,5-dimethoxyamphetamine.
4-hydroxycoumarinThe metabolism of 4-hydroxycoumarin can be increased when combined with Esketamine.
4-MethoxyamphetamineThe risk or severity of hypertension can be increased when Esketamine is combined with 4-Methoxyamphetamine.
5-methoxy-N,N-dimethyltryptamineThe risk or severity of hypertension can be increased when Esketamine is combined with 5-methoxy-N,N-dimethyltryptamine.
Additional Data Available
  • Extended Description
    Extended Description

    Extended description of the mechanism of action and particular properties of each drug interaction.

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  • Severity
    Severity

    A severity rating for each drug interaction, from minor to major.

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  • Evidence Level
    Evidence Level

    A rating for the strength of the evidence supporting each drug interaction.

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  • Action
    Action

    An effect category for each drug interaction. Know how this interaction affects the subject drug.

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Food Interactions
Not Available

References

General References
  1. Morrison RL, Fedgchin M, Singh J, Van Gerven J, Zuiker R, Lim KS, van der Ark P, Wajs E, Xi L, Zannikos P, Drevets WC: Effect of intranasal esketamine on cognitive functioning in healthy participants: a randomized, double-blind, placebo-controlled study. Psychopharmacology (Berl). 2018 Apr;235(4):1107-1119. doi: 10.1007/s00213-018-4828-5. Epub 2018 Feb 1. [PubMed:29392371]
  2. Jonkman K, Duma A, Olofsen E, Henthorn T, van Velzen M, Mooren R, Siebers L, van den Beukel J, Aarts L, Niesters M, Dahan A: Pharmacokinetics and Bioavailability of Inhaled Esketamine in Healthy Volunteers. Anesthesiology. 2017 Oct;127(4):675-683. doi: 10.1097/ALN.0000000000001798. [PubMed:28759464]
  3. Turecki G, Brent DA: Suicide and suicidal behaviour. Lancet. 2016 Mar 19;387(10024):1227-39. doi: 10.1016/S0140-6736(15)00234-2. Epub 2015 Sep 15. [PubMed:26385066]
  4. FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor’s office or clinic [Link]
  5. WHO International fact sheet [Link]
  6. Janssen slides, esketamine [File]
External Links
KEGG Drug
D07283
PubChem Compound
182137
PubChem Substance
347828170
ChemSpider
158414
ChEBI
60799
ChEMBL
CHEMBL395091
Wikipedia
Esketamine
ATC Codes
N01AX14 — Esketamine
FDA label
Download (965 KB)
MSDS
Download (36.8 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1Active Not RecruitingTreatmentHepatic Impairment / Normal Hepatic Function1
1CompletedNot AvailableHealthy Volunteers1
1CompletedNot AvailablePain1
1CompletedOtherHealthy Volunteers2
1CompletedPreventionHealthy Volunteers1
1CompletedTreatmentAllergic Rhinitis (AR)1
1CompletedTreatmentHealthy Volunteers11
1CompletedTreatmentHealthy Volunteers / Impaired Renal Function1
1CompletedTreatmentMajor Depressive Disorder (MDD)1
1CompletedTreatmentSubstance Abuse1
1RecruitingTreatmentHealthy Volunteers1
2Active Not RecruitingTreatmentDepression1
2CompletedTreatmentAnaesthesia therapy / Hysterectomy / Ketamine / Morphine1
2CompletedTreatmentMajor Depressive Disorder (MDD)2
2CompletedTreatmentTreatment Resistant Depressive Disorder1
2RecruitingTreatmentDepression, Bipolar1
2RecruitingTreatmentDepression / Ketamine1
2RecruitingTreatmentMajor Depressive Disorder (MDD)2
2, 3CompletedTreatmentAnalgesia, Patient-Controlled / Spinal Stenosis1
2, 3CompletedTreatmentChronic Pain, Widespread / Pain, Acute / Schizophrenic Disorders1
3CompletedTreatmentDepressive Disorder, Treatment-Resistant / Major depressive disorder, recurrent episode2
3CompletedTreatmentMajor Depressive Disorder (MDD)2
3CompletedTreatmentMajor depressive disorder, recurrent episode3
3CompletedTreatmentPain1
3Not Yet RecruitingTreatmentDepressive Disorder, Treatment-Resistant1
3RecruitingTreatmentDepressive Disorder, Treatment-Resistant2
4CompletedBasic ScienceAnaesthesia therapy / Loss of Consciousness1
4CompletedBasic ScienceHealthy Volunteers1
4CompletedDiagnosticToothache1
4CompletedTreatmentAnalgesics / Pain, Chronic / Postoperative pain1
4RecruitingTreatmentAcute Pain Due to Trauma1
4RecruitingTreatmentPostoperative pain1
4RecruitingTreatmentSurfactant Deficiency Syndrome Neonatal1
4Unknown StatusTreatmentCholecystolithiasis1
4Unknown StatusTreatmentPlanned Abdominal Hysterectomy1
Not AvailableApproved for MarketingNot AvailableDepressive Disorder, Treatment-Resistant1
Not AvailableCompletedBasic ScienceAbnormal Vascular Flow / Healthy Volunteers1
Not AvailableCompletedBasic ScienceHealthy Volunteers1
Not AvailableRecruitingTreatmentBMI >30 kg/m2 / Postoperative pain1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
SolutionNasal28 mg/0.2mL
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US8785500No2014-07-222031-07-09Us
US9592207No2017-03-142027-03-20Us
Additional Data Available
  • Filed On
    Filed On

    The date on which a patent was filed with the relevant government.

    Learn more

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)92.5http://pharmacycode.com/Esketamine.html
boiling point (°C)363.8ºC at 760mmHghttps://www.chemsrc.com/en/cas/33643-46-8_146615.html
water solubilityfeely soluble in waterFDA label
logP3.28870https://www.chemsrc.com/en/cas/33643-46-8_146615.html
pKa7.5https://edoc.unibas.ch/1310/1/20110314_1408_DissCB_e_version.pdf
Predicted Properties
PropertyValueSource
Water Solubility0.0464 mg/mLALOGPS
logP2.69ALOGPS
logP3.35ChemAxon
logS-3.7ALOGPS
pKa (Strongest Acidic)19.77ChemAxon
pKa (Strongest Basic)7.16ChemAxon
Physiological Charge1ChemAxon
Hydrogen Acceptor Count2ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area29.1 Å2ChemAxon
Rotatable Bond Count2ChemAxon
Refractivity65.55 m3·mol-1ChemAxon
Polarizability24.97 Å3ChemAxon
Number of Rings2ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterYesChemAxon
Veber's RuleYesChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as chlorobenzenes. These are compounds containing one or more chlorine atoms attached to a benzene moiety.
Kingdom
Organic compounds
Super Class
Benzenoids
Class
Benzene and substituted derivatives
Sub Class
Halobenzenes
Direct Parent
Chlorobenzenes
Alternative Parents
Aralkylamines / Aryl chlorides / Cyclic ketones / Dialkylamines / Organopnictogen compounds / Organochlorides / Organic oxides / Hydrocarbon derivatives
Substituents
Chlorobenzene / Aralkylamine / Aryl chloride / Aryl halide / Ketone / Cyclic ketone / Secondary aliphatic amine / Secondary amine / Amine / Organooxygen compound
Molecular Framework
Aromatic homomonocyclic compounds
External Descriptors
ketamine (CHEBI:60799)

Targets

Kind
Protein group
Organism
Humans
Pharmacological action
Unknown
Actions
Antagonist
General Function
Voltage-gated cation channel activity
Specific Function
NMDA receptor subtype of glutamate-gated ion channels with high calcium permeability and voltage-dependent sensitivity to magnesium. Mediated by glycine. This protein plays a key role in synaptic p...

Components:
References
  1. Morrison RL, Fedgchin M, Singh J, Van Gerven J, Zuiker R, Lim KS, van der Ark P, Wajs E, Xi L, Zannikos P, Drevets WC: Effect of intranasal esketamine on cognitive functioning in healthy participants: a randomized, double-blind, placebo-controlled study. Psychopharmacology (Berl). 2018 Apr;235(4):1107-1119. doi: 10.1007/s00213-018-4828-5. Epub 2018 Feb 1. [PubMed:29392371]
  2. Spravato FDA label [File]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Antagonist
Curator comments
Possible target.
General Function
Zinc ion binding
Specific Function
NMDA receptor subtype of glutamate-gated ion channels with high calcium permeability and voltage-dependent sensitivity to magnesium. Mediated by glycine. In concert with DAPK1 at extrasynaptic site...
Gene Name
GRIN2B
Uniprot ID
Q13224
Uniprot Name
Glutamate receptor ionotropic, NMDA 2B
Molecular Weight
166365.885 Da
References
  1. Molero P, Ramos-Quiroga JA, Martin-Santos R, Calvo-Sanchez E, Gutierrez-Rojas L, Meana JJ: Antidepressant Efficacy and Tolerability of Ketamine and Esketamine: A Critical Review. CNS Drugs. 2018 May;32(5):411-420. doi: 10.1007/s40263-018-0519-3. [PubMed:29736744]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Translation elongation factor activity
Specific Function
Catalyzes the GTP-dependent ribosomal translocation step during translation elongation. During this step, the ribosome changes from the pre-translocational (PRE) to the post-translocational (POST) ...
Gene Name
EEF2
Uniprot ID
P13639
Uniprot Name
Elongation factor 2
Molecular Weight
95337.385 Da
References
  1. Molero P, Ramos-Quiroga JA, Martin-Santos R, Calvo-Sanchez E, Gutierrez-Rojas L, Meana JJ: Antidepressant Efficacy and Tolerability of Ketamine and Esketamine: A Critical Review. CNS Drugs. 2018 May;32(5):411-420. doi: 10.1007/s40263-018-0519-3. [PubMed:29736744]
  2. Zanos P, Thompson SM, Duman RS, Zarate CA Jr, Gould TD: Convergent Mechanisms Underlying Rapid Antidepressant Action. CNS Drugs. 2018 Mar;32(3):197-227. doi: 10.1007/s40263-018-0492-x. [PubMed:29516301]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Agonist
Curator comments
Possible target.
General Function
Neurotrophin trkb receptor binding
Specific Function
During development, promotes the survival and differentiation of selected neuronal populations of the peripheral and central nervous systems. Participates in axonal growth, pathfinding and in the m...
Gene Name
BDNF
Uniprot ID
P23560
Uniprot Name
Brain-derived neurotrophic factor
Molecular Weight
27817.72 Da
References
  1. Molero P, Ramos-Quiroga JA, Martin-Santos R, Calvo-Sanchez E, Gutierrez-Rojas L, Meana JJ: Antidepressant Efficacy and Tolerability of Ketamine and Esketamine: A Critical Review. CNS Drugs. 2018 May;32(5):411-420. doi: 10.1007/s40263-018-0519-3. [PubMed:29736744]
  2. Haile CN, Murrough JW, Iosifescu DV, Chang LC, Al Jurdi RK, Foulkes A, Iqbal S, Mahoney JJ 3rd, De La Garza R 2nd, Charney DS, Newton TF, Mathew SJ: Plasma brain derived neurotrophic factor (BDNF) and response to ketamine in treatment-resistant depression. Int J Neuropsychopharmacol. 2014 Feb;17(2):331-6. doi: 10.1017/S1461145713001119. Epub 2013 Oct 8. [PubMed:24103211]
  3. Autry AE, Monteggia LM: Brain-derived neurotrophic factor and neuropsychiatric disorders. Pharmacol Rev. 2012 Apr;64(2):238-58. doi: 10.1124/pr.111.005108. Epub 2012 Mar 8. [PubMed:22407616]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Curator comments
Possible target.
General Function
Protein homodimerization activity
Specific Function
Receptor tyrosine kinase involved in the development and the maturation of the central and the peripheral nervous systems through regulation of neuron survival, proliferation, migration, differenti...
Gene Name
NTRK2
Uniprot ID
Q16620
Uniprot Name
BDNF/NT-3 growth factors receptor
Molecular Weight
91998.175 Da
References
  1. Molero P, Ramos-Quiroga JA, Martin-Santos R, Calvo-Sanchez E, Gutierrez-Rojas L, Meana JJ: Antidepressant Efficacy and Tolerability of Ketamine and Esketamine: A Critical Review. CNS Drugs. 2018 May;32(5):411-420. doi: 10.1007/s40263-018-0519-3. [PubMed:29736744]
  2. Autry AE, Monteggia LM: Brain-derived neurotrophic factor and neuropsychiatric disorders. Pharmacol Rev. 2012 Apr;64(2):238-58. doi: 10.1124/pr.111.005108. Epub 2012 Mar 8. [PubMed:22407616]
  3. van de Loo AJAE, Bervoets AC, Mooren L, Bouwmeester NH, Garssen J, Zuiker R, van Amerongen G, van Gerven J, Singh J, der Ark PV, Fedgchin M, Morrison R, Wajs E, Verster JC: The effects of intranasal esketamine (84 mg) and oral mirtazapine (30 mg) on on-road driving performance: a double-blind, placebo-controlled study. Psychopharmacology (Berl). 2017 Nov;234(21):3175-3183. doi: 10.1007/s00213-017-4706-6. Epub 2017 Jul 28. [PubMed:28755104]

Enzymes

Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inducer
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2B6
Uniprot ID
P20813
Uniprot Name
Cytochrome P450 2B6
Molecular Weight
56277.81 Da
References
  1. Hijazi Y, Boulieu R: Contribution of CYP3A4, CYP2B6, and CYP2C9 isoforms to N-demethylation of ketamine in human liver microsomes. Drug Metab Dispos. 2002 Jul;30(7):853-8. [PubMed:12065445]
  2. Ricardo Jorge Dinis-Oliveira (2017). Metabolism and metabolomics of ketamine: a toxicological approach. Taylor & Francis Group.
  3. Spravato FDA label [File]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
Inducer
General Function
Vitamin d3 25-hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
Gene Name
CYP3A4
Uniprot ID
P08684
Uniprot Name
Cytochrome P450 3A4
Molecular Weight
57342.67 Da
References
  1. Hijazi Y, Boulieu R: Contribution of CYP3A4, CYP2B6, and CYP2C9 isoforms to N-demethylation of ketamine in human liver microsomes. Drug Metab Dispos. 2002 Jul;30(7):853-8. [PubMed:12065445]
  2. Ricardo Jorge Dinis-Oliveira (2017). Metabolism and metabolomics of ketamine: a toxicological approach. Taylor & Francis Group.
  3. Spravato FDA label [File]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Responsible for the metabolism of a number of therapeutic agents such as the anticonvulsant drug S-mephenytoin, omeprazole, proguanil, certain barbiturates, diazepam, propranolol, citalopram and im...
Gene Name
CYP2C19
Uniprot ID
P33261
Uniprot Name
Cytochrome P450 2C19
Molecular Weight
55930.545 Da
References
  1. Ricardo Jorge Dinis-Oliveira (2017). Metabolism and metabolomics of ketamine: a toxicological approach. Taylor & Francis Group.
  2. Spravato FDA label [File]
Kind
Protein
Organism
Humans
Pharmacological action
Unknown
Actions
Substrate
General Function
Steroid hydroxylase activity
Specific Function
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally un...
Gene Name
CYP2C9
Uniprot ID
P11712
Uniprot Name
Cytochrome P450 2C9
Molecular Weight
55627.365 Da
References
  1. Hijazi Y, Boulieu R: Contribution of CYP3A4, CYP2B6, and CYP2C9 isoforms to N-demethylation of ketamine in human liver microsomes. Drug Metab Dispos. 2002 Jul;30(7):853-8. [PubMed:12065445]
  2. Ricardo Jorge Dinis-Oliveira (2017). Metabolism and metabolomics of ketamine: a toxicological approach. Taylor & Francis Group.
  3. Spravato FDA label [File]

Drug created on October 20, 2016 14:51 / Updated on November 02, 2019 04:34