Treatment-resistant depression (TRD) is defined as failing at least two adequate antidepressant trials. Esketamine, the S-enantiomer of ketamine, has been approved for TRD by the U.S. FDA and European Medicines Agency, but misconceptions about it persist among clinicians and patients. This review searched databases for keywords including "esketamine" and "myth" to identify false beliefs. Common myths included misunderstandings about TRD prevalence, clinical features, and predictors, as well as esketamine's treatment criteria, dissociative symptoms, addiction potential, and administration. Evidence-based facts counter these myths, showing esketamine is effective for TRD with necessary precautions, and accurate diagnosis is key to recovery.
Depression involves a wide range of emotional, cognitive, and physical symptoms that disrupt daily life. Societal changes such as technological advances, economic pressures, climate change, and shifting cultural norms have altered how depression appears and is understood, leading to the identification of new depression subtypes. These include depression in adolescents and young adults, depression with social disconnection, depression with alcohol or substance use disorder, depression with gender dysphoria, and depression linked to stressful events and environmental factors. Managing these subtypes requires individualized treatment approaches. While SSRIs and SNRIs remain standard, atypical antidepressants like trazodone, ketamine, neuromodulation, and personalized psychotherapy offer hope for complex or treatment-resistant cases.