Targeting metabotropic glutamate receptors for rapid-acting antidepressant drug discovery

Introduction Depression is a highly debilitating psychiatric disorder and a worldwide health issue. Functional deficits in glutamatergic cortico-limbic areas are hypothesized to play a key role in the pathogenesis of the disease. Consistently, the clinical antidepressant efficacy of the N-Methyl-D-aspartate (NMDA) receptor antagonist ketamine gives hope for a new class of glutamatergic rapid-acting antidepressants. In this context, metabotropic glutamate (mGlu) receptors have received attention as interesting targets for new antidepressants. Areas covered The present review summarizes the preclinical evidence supporting the antidepressant effect of the pharmacological modulation of mGlu receptors. Antidepressant properties in animal models of mGlu1 antagonists, mGlu5 negative allosteric modulators (NAMs) and positive allosteric modulators (PAMs), mGlu2/3 agonists, PAMs, orthosteric antagonists and NAMs, mGlu4 and mGlu7 PAMs are reviewed. To date, orthosteric mGlu2/3 antagonists are the most promising compounds in development as antidepressants. Expert opinion Although accumulating clinical and preclinical evidence concur to confirm a primary role of glutamate transmission modulation for the induction of a rapid antidepressant effect, very little is still known about the cellular mechanisms involved. More mechanistic studies are required to understand the role of glutamate in depression and the therapeutic potential of drugs directly targeting the glutamate synapse.

Automated summary

This review focuses on the antidepressant effect of pharmacological modulation of metabotropic glutamate (mGlu) receptors, highlighting mGlu2/3 antagonists as the most promising compounds for the development of new antidepressants. Despite accumulating evidence supporting the role of glutamate modulation in rapid antidepressant effects, more mechanistic studies are needed to fully understand the potential of drugs targeting the glutamate synapse in depression.