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Ketamine was initially developed as an anesthetic, but today it is also used as an analgesic and an antidepressant. It has been used as a recreational drug since the 1970s. After administration, ketamine is rapidly and extensively metabolized into an active metabolite called norketamine, which is thought to play an important role in ketamines anesthetic and analgesic effects. Ketamine and norketamine both act at a receptor for the neurotransmitter glutamate called the NMDA receptor. Glutamate is the primary excitatory neurotransmitter in the brain, and ketamine and norketamine act as antagonists at the NMDA receptor, which means that they block the receptor and inhibit activity there. Inhibition of NMDA receptors can substantially affect neurotransmission, and is thought to be critical to the anesthetic and analgesic effects of ketamine. While most other antidepressants take several weeks to achieve a therapeutic effect, ketamine can begin to improve depressive symptoms within hours a
