Fig. 1: Chemical structure of enantiomers of ketamine and its metabolites. | Translational Psychiatry

Fig. 1: Chemical structure of enantiomers of ketamine and its metabolites.

From: Molecular and cellular mechanisms underlying the antidepressant effects of ketamine enantiomers and its metabolites

Fig. 1

(R)-ketamine [or (S)-ketamine] is initially metabolized to (R)-norketamine [or (S)-norketamine] by either CYP2B6 or CYP3A4, and then metabolized to (R)-dehydronorketamine (DHNK) [or (S)-DHNK]. Hydroxylation of (R)-norketamine [or (S)-norketamine] at the sixth position by CYP2A6 results in (2R,6R)-hydroxynorketamine (HNK) [or (2S,6S)-HNK]. (R)-ketamine [or (S)-ketamine] is also metabolized to (2R,6R)-hydroxyketamine (HK) [or (2S,6S)-HK], then to (2R,6R)-HNK [or (2S,6S)-HNK]49. The values in the parenthesis are the Ki value for the NMDAR37,41

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