The rise of ketamine and brexanolone as rapid antidepressant treatments raises the question of common mechanisms. Both drugs act without the long onset time of traditional antidepressants such as selective serotonin reuptake inhibitors. The drugs also share the interesting feature of benefit that persists beyond the initial drug lifetime. Here, we briefly review literature on functional changes that may mark the triggering mechanism of rapid antidepressant actions. Because ketamine has a longer history of study as a rapid antidepressant, we use this literature as a template to guide hypotheses about common action. Brexanolone has the complication of being a formulation of a naturally occurring neurosteroid; thus, endogenous levels need to be considered when studying the impact of exogenous administration. We conclude that network disinhibition and increased high-frequency oscillations are candidates to mediate acute triggering effects of rapid antidepressants.

中文翻译：

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allopregnanolone 快速抗抑郁作用的生理标志物

氯胺酮和 brexanolone 作为快速抗抑郁药的兴起引发了共同机制的问题。这两种药物的作用都没有传统抗抑郁药（如选择性 5-羟色胺再摄取抑制剂）的长起效时间。这些药物还具有一个有趣的特征，即在初始药物寿命之后持续存在的益处。在这里，我们简要回顾了有关功能变化的文献，这些功能变化可能标志着快速抗抑郁作用的触发机制。由于氯胺酮作为一种快速抗抑郁药的研究历史较长，因此我们使用该文献作为模板来指导关于共同作用的假设。Brexanolone 是天然存在的神经类固醇制剂的并发症；因此，在研究外源性管理的影响时需要考虑内源性水平。