[Ketamine and other N-methyl-D-aspartate receptor modulators in treatment of depression].

Since the first successful ketamine application in treatment-resistant depressive patients, the newly developed pharmaceutical class of rapid-acting antidepressants has been intensively investigated. The underlying mechanism of action by influencing the glutamatergic neurotransmission via a modulation of N‑methyl-D-aspartate (NMDA) receptors, represents a completely new and promising interventional strategy in the treatment of affective disorders. In this very dynamic field, Spravato® (esketamine) is so far the only approved drug; however, many other substances are currently in the development and evaluation processes. This narrative review provides a critical overview of the most important substances, target structures and developmental stages of NMDAR modulators.