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The effects of antidepressants on [neuronal] plasticity do not, therefore, require increases in the serotonin levels or the inhibition of glutamate receptors, as previously thought." "Previous studies have shown that in SSRI therapy, drugs gradually reach the high brain concentration needed for binding to the TrkB receptor, whereas intravenously administered ketamine and esketamine as a nasal spray [i.e., Spravato] reach the level needed for binding quickly, in a matter of minutes," Castrn added