Ovarian hormones mediate the prophylactic efficacy of (R,S)-ketamine and (2R,6R)-hydroxynorketamine in female mice

BACKGROUND Females are more likely than males to develop major depressive disorder (MDD) after exposure to stress. We previously reported that the administration of (R,S)-ketamine before stress can prevent stress-induced depressive-like behavior in male mice but have yet to assess efficacy in female mice or for other compounds, such as the metabolites of (R,S)-ketamine. METHODS We administered (R,S)-ketamine or its metabolites (2R,6R)-hydroxynorketamine ((2R,6R)-HNK) and (2S,6S)-HNK at various doses 1 week before one of a number of stressors, including contextual fear conditioning (CFC), learned helplessness (LH), and chronic immobilization stress (CIS), in male and female 129S6/SvEv mice. To examine the interaction between ovarian hormones and stress resilience, female mice also underwent ovariectomy surgery (OVX) and a hormone replacement protocol prior to drug administration. RESULTS (R,S)-ketamine and (2S,6S)-HNK, but not (2R,6R)-HNK, attenuated learned fear in male mice. (R,S)-ketamine and (2R,6R)-HNK, but not (2S,6S)-HNK, significantly reduced stress-induced depressive-like behavior in male and female mice. (R,S)-ketamine and (2R,6R)-HNK) were prophylactically effective at a lower dose (10 mg/kg and 0.025 mg/kg, respectively) in female mice than in male mice (30 mg/kg and 0.075 mg/kg, respectively). Moreover, ovarian-derived hormones were necessary and sufficient for prophylaxis in female mice. CONCLUSIONS Our results suggest that prophylactics against stress-induced depressive-like behavior can be developed in a sex-specific manner and that ovarian hormones mediate prophylactic efficacy in females. To our knowledge, this is the first demonstration of the prophylactic efficacy of the metabolites of (R,S)-ketamine in male and female mice.

[1]  D. Buhl,et al.  Pharmacological evaluation of clinically relevant concentrations of (2R,6R)-hydroxynorketamine , 2019, Neuropharmacology.

[2]  Brendon O. Watson,et al.  Stress-sensitive antidepressant-like effects of ketamine in the mouse forced swim test , 2019, PloS one.

[3]  J. Fadiman,et al.  Might Microdosing Psychedelics Be Safe and Beneficial? An Initial Exploration , 2019, Journal of psychoactive drugs.

[4]  Ina P. Pavlova,et al.  Ventral CA3 Activation Mediates Prophylactic Ketamine Efficacy Against Stress-Induced Depressive-like Behavior , 2018, Biological Psychiatry.

[5]  B. Hommel,et al.  Exploring the effect of microdosing psychedelics on creativity in an open-label natural setting , 2018, Psychopharmacology.

[6]  R. Stevenson,et al.  A systematic study of microdosing psychedelics , 2018, PloS one.

[7]  K. Hashimoto,et al.  (2R,6R)-Hydroxynorketamine is not essential for the antidepressant actions of (R)-ketamine in mice , 2018, Neuropsychopharmacology.

[8]  J. McGowan,et al.  Prophylactic ketamine alters nucleotide and neurotransmitter metabolism in brain and plasma following stress , 2018, Neuropsychopharmacology.

[9]  M. Kabbaj,et al.  Behavioral and biochemical sensitivity to low doses of ketamine: Influence of estrous cycle in C57BL/6 mice , 2018, Neuropharmacology.

[10]  Samuel D. Dolzani,et al.  Inhibition of a Descending Prefrontal Circuit Prevents Ketamine-Induced Stress Resilience in Females , 2018, eNeuro.

[11]  R. Shelton,et al.  Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression: A Randomized Clinical Trial , 2017, JAMA psychiatry.

[12]  R. Banati,et al.  Microdosing, isotopic labeling, radiotracers and metabolomics: relevance in drug discovery, development and safety. , 2017, Bioanalysis.

[13]  C. Denny,et al.  Common Neurotransmission Recruited in (R,S)-Ketamine and (2R,6R)-Hydroxynorketamine–Induced Sustained Antidepressant-like Effects , 2017, Biological Psychiatry.

[14]  A. Phillips,et al.  Antidepressant effects of ketamine and the roles of AMPA glutamate receptors and other mechanisms beyond NMDA receptor antagonism , 2017, Journal of psychiatry & neuroscience : JPN.

[15]  E. Kavalali,et al.  Effects of a ketamine metabolite on synaptic NMDAR function , 2017, Nature.

[16]  S. Kennedy,et al.  Oral Ketamine in Treatment-Resistant Depression , 2017, Journal of clinical psychopharmacology.

[17]  Tal Burt,et al.  Phase-0/microdosing studies using PET, AMS, and LC-MS/MS: a range of study methodologies and conduct considerations. Accelerating development of novel pharmaceuticals through safe testing in humans – a practical guide , 2017, Expert opinion on drug delivery.

[18]  K. Hashimoto,et al.  Antidepressant Potential of (R)-Ketamine in Rodent Models: Comparison with (S)-Ketamine , 2017, The Journal of Pharmacology and Experimental Therapeutics.

[19]  J. McGowan,et al.  Prophylactic Ketamine Attenuates Learned Fear , 2017, Neuropsychopharmacology.

[20]  Husseini Manji,et al.  Intravenous Esketamine in Adult Treatment-Resistant Depression: A Double-Blind, Double-Randomization, Placebo-Controlled Study , 2016, Biological Psychiatry.

[21]  R. Hen,et al.  Ketamine as a Prophylactic Against Stress-Induced Depressive-like Behavior , 2016, Biological Psychiatry.

[22]  Xi-Ping Huang,et al.  NMDAR inhibition-independent antidepressant actions of ketamine metabolites , 2016, Nature.

[23]  M Rowland,et al.  Microdosing and Other Phase 0 Clinical Trials: Facilitating Translation in Drug Development , 2016, Clinical and translational science.

[24]  K. Schoepfer,et al.  Hedonic sensitivity to low-dose ketamine is modulated by gonadal hormones in a sex-dependent manner , 2016, Scientific Reports.

[25]  S. Maier,et al.  Previous Ketamine Produces an Enduring Blockade of Neurochemical and Behavioral Effects of Uncontrollable Stress , 2016, The Journal of Neuroscience.

[26]  Graham Lappin,et al.  The expanding utility of microdosing , 2015, Clinical pharmacology in drug development.

[27]  K. Hashimoto,et al.  R-ketamine: a rapid-onset and sustained antidepressant without psychotomimetic side effects , 2015, Translational Psychiatry.

[28]  Janine D. Flory,et al.  Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations , 2015, Dialogues in clinical neuroscience.

[29]  P. Pitychoutis,et al.  Sex differences in the rapid and the sustained antidepressant-like effects of ketamine in stress-naïve and “depressed” mice exposed to chronic mild stress , 2015, Neuroscience.

[30]  N. Kokras,et al.  Sex differences in animal models of psychiatric disorders , 2014, British journal of pharmacology.

[31]  R. Howland,et al.  The Role of Ketamine in Treatment-Resistant Depression: A Systematic Review , 2014, Current neuropharmacology.

[32]  C. Neill Epperson,et al.  Sex differences in anxiety and depression clinical perspectives , 2014, Frontiers in Neuroendocrinology.

[33]  K. Hashimoto,et al.  R (−)-ketamine shows greater potency and longer lasting antidepressant effects than S (+)-ketamine , 2014, Pharmacology Biochemistry and Behavior.

[34]  I. Lucki,et al.  Antidepressant effects of ketamine: mechanisms underlying fast-acting novel antidepressants , 2013, Front. Pharmacol..

[35]  M. Kabbaj,et al.  Sex differences in the antidepressant-like effects of ketamine , 2013, Neuropharmacology.

[36]  Tal Burt,et al.  Microdosing and drug development: past, present and future , 2013, Expert opinion on drug metabolism & toxicology.

[37]  G. Mion,et al.  Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings) , 2013, CNS neuroscience & therapeutics.

[38]  G. Laje,et al.  Relationship of Ketamine's Plasma Metabolites with Response, Diagnosis, and Side Effects in Major Depression , 2012, Biological Psychiatry.

[39]  K. S. Al-Harbi Treatment-resistant depression: therapeutic trends, challenges, and future directions , 2012, Patient preference and adherence.

[40]  Liz Searle,et al.  Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention , 2011 .

[41]  E. Kavalali,et al.  NMDA Receptor Blockade at Rest Triggers Rapid Behavioural Antidepressant Responses , 2011, Nature.

[42]  J. Morrison,et al.  Estrogen promotes stress sensitivity in a prefrontal cortex-amygdala pathway. , 2010, Cerebral cortex.

[43]  Leslie J. Sim,et al.  Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention , 2009 .

[44]  D. Waxman,et al.  Sex Differences in the Expression of Hepatic Drug Metabolizing Enzymes , 2009, Molecular Pharmacology.

[45]  T. Shors,et al.  Females do not Express Learned Helplessness like Males do , 2008, Neuropsychopharmacology.

[46]  Paul J Carlson,et al.  A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. , 2006, Archives of general psychiatry.

[47]  Olga V. Demler,et al.  Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[48]  R. Davidson,et al.  Depression: perspectives from affective neuroscience. , 2002, Annual review of psychology.

[49]  G. Wilkinson,et al.  Gender differences in depression. Critical review. , 2000, The British journal of psychiatry : the journal of mental science.

[50]  M. Thase,et al.  Gender differences in treatment response to sertraline versus imipramine in chronic depression. , 2000, The American journal of psychiatry.

[51]  R. Porsolt,et al.  Depression: a new animal model sensitive to antidepressant treatments , 1977, Nature.

[52]  Sieto Bosgra,et al.  To Apply Microdosing or Not? Recommendations to Single Out Compounds with Non-Linear Pharmacokinetics , 2015, Clinical Pharmacokinetics.

[53]  D. Mattison,et al.  Sex Differences in Pharmacokinetics and Pharmacodynamics , 2009, Clinical pharmacokinetics.

[54]  J. Schwartz The Influence of Sex on Pharmacokinetics , 2003, Clinical pharmacokinetics.

[55]  K. Korach,et al.  Estrogen receptors are essential for female sexual receptivity. , 1997, Endocrinology.

[56]  S. Kornstein Gender differences in depression: implications for treatment. , 1997, The Journal of clinical psychiatry.

[57]  E. Susser,et al.  Divalproex treatment of disruptive adolescents: a report of 10 cases. , 1997, The Journal of clinical psychiatry.