Sub-anesthetic ketamine produces rapid antidepressant effects in patients with bipolar and unipolar major depression where conventional monoaminergic-based antidepressant drugs have been ineffective or ridden with side effects. A single ketamine infusion can produce antidepressant effects lasting up to two weeks, and multiple ketamine infusions prolong this effect. Pre-clinical studies are underway to uncover ketamine's mechanisms of action, but there are still many questions unanswered regarding the safety of its long-term use. Abuse liability is one area of concern, as recreational ketamine use is an ongoing issue in many parts of the world. Another understudied area is sex differences in responsivity to ketamine. Women are twice as likely as men to be diagnosed with depression, and they progress through stages of drug addiction more rapidly than their male counterparts. Despite this, preclinical studies in ketamine's antidepressant and addictive-like behaviors in females are limited. These intersecting factors in recent clinical and pre-clinical studies are reviewed to characterize ketamine's therapeutic potential, its limitations, and its potential mechanisms of action.

亚麻醉性氯胺酮在双相和单相重度抑郁症患者中产生快速的抗抑郁作用，而传统的基于单胺能的抗抑郁药无效或有副作用。单次氯胺酮输注可产生持续两周的抗抑郁作用，多次氯胺酮输注可延长这种作用。目前正在开展临床前研究，以发现氯胺酮的作用机理，但关于长期使用氯胺酮的安全性，仍有许多问题尚未解答。滥用责任是一个令人关注的领域，因为休闲氯胺酮的使用在世界许多地方都是一个持续存在的问题。另一个尚未被研究的领域是对氯胺酮的反应性存在性别差异。女性被诊断出患有抑郁症的可能性是男性的两倍，与男性相比，他们在吸毒阶段的进步更快。尽管如此，氯胺酮在女性中的抗抑郁和成瘾性行为的临床前研究仍然有限。审查了近期临床和临床前研究中的这些交叉因素，以表征氯胺酮的治疗潜力，局限性及其潜在的作用机制。