It is Possible Find an Antidepressant with Faster Onset of Action? Ketamine: Promise or Reality?

Monoaminergic antidepressants have a delay in the onset of response that needs alternatives. Sub anesthetic doses of ketamine, a NMDA receptor antagonist, show a rapid-acting antidepressant effect in Major Depressive Disorder (MDD) and in bipolar depression, and improve suicidal ideation. However, for ketamine routinely use as antidepressant, more clinical research on the relation risks and benefits is needed to decide if ketamine is a promise or a reality.