Glossary Articles
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Norketamine: Ketamine's Primary Metabolite Explained
What norketamine is, its half-life, pharmacological activity vs parent ketamine, and why this metabolite is central to how oral and sublingual ketamine work.
Enantiomer: Definition and Relevance to Ketamine
A definition of enantiomers — mirror-image molecular forms — and their critical importance in understanding ketamine's two forms: esketamine (S-ketamine) and arketamine (R-ketamine).
First-Pass Metabolism: How Liver Processing Affects Oral Ketamine
A definition of first-pass metabolism — the hepatic processing that reduces oral drug bioavailability — and its specific impact on oral ketamine formulations.
Treatment-Resistant Depression (TRD): Definition, Criteria, and Significance for Ketamine
Treatment-resistant depression (TRD) defined: clinical criteria, the two-failed-trials threshold, and why TRD is the primary indication for ketamine therapy.
GABA (Gamma-Aminobutyric Acid): The Brain's Primary Inhibitory Neurotransmitter
A definition of GABA — the brain's main inhibitory neurotransmitter — and its relationship to ketamine's mechanism of action and therapeutic effects.
Sub-Anesthetic Dose: The Therapeutic Range for Ketamine in Depression
A definition of sub-anesthetic dosing — the low-dose ketamine range used to treat depression — including typical dosages, rationale, and how it differs from anesthetic use.
Glutamatergic System: The Excitatory Signaling Network Behind Ketamine's Effects
An overview of the glutamatergic system — the brain's primary excitatory neurotransmitter network — and its central role in how ketamine produces rapid antidepressant effects.
Compounding Pharmacy: Custom Ketamine Formulations Explained
How compounding pharmacies prepare ketamine: troches, lozenges, nasal sprays, 503A vs 503B oversight, FDA limits, and what to ask before ordering.
mTOR Pathway: Ketamine's Role in Protein Synthesis and Synaptic Growth
A definition of the mTOR (mechanistic target of rapamycin) signaling pathway and its critical role in how ketamine promotes rapid synaptogenesis and antidepressant effects.
Serotonin Syndrome: Risks, Symptoms, and Relevance to Ketamine Therapy
Serotonin syndrome explained: symptoms, drug combinations that trigger it, and why patients on SSRIs or MAOIs need to discuss the risk before starting ketamine.
Racemic Mixture: S-Ketamine and R-Ketamine Enantiomers Explained
A definition of racemic mixture in the context of ketamine therapy — explaining the S and R enantiomers, their different pharmacological profiles, and clinical implications.
Schedule III Controlled Substance: Ketamine's DEA Classification Explained
Why ketamine is a Schedule III controlled substance: DEA criteria, prescribing rules, refill limits, telehealth implications, and how it compares to II and IV.
Default Mode Network: How Ketamine Disrupts Depressive Thought Patterns
An explanation of the default mode network (DMN), its role in rumination and depression, and how ketamine modulates DMN activity to relieve depressive symptoms.