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Hyperpigmentation of the oral mucosa affects up to 92% of patients and can precede other manifestations by up to 10 years

The brain-derived neurotrophic factor (BDNF) and its receptor, tyrosine kinase receptor B (TrkB), are essential and common mechanisms for the antidepressant effects of both the parent molecules of ketamines [i.e., S, R()ketamine, S(+)ketamine, and R()ketamine] and their active metabolites [i.e., (2R,6R)-hydroxynorketamine and of S(+)norketamine] (Yang et al., 2019)