Journal of Affective Disorders
October 12, 2026
Reinhard Janssen-Aguilar, Jithin Joseph, Huda Al-Shamali et al.
Treatment-resistant depression (TRD) affects 30-60% of individuals with major depressive disorder and carries substantial morbidity and healthcare costs. Intravenous (IV) ketamine (KET) is a rapid-acting antidepressant, but benefits are often transient, prompting augmentation to sustain efficacy or improve tolerability. We conducted a systematic review and meta-analysis of randomized controlled...
The International Journal of Neuropsychopharmacology
September 1, 2026
A Nunes, J E Cunningham, B Leden et al.
Abstract Background Use of intravenous ketamine or intranasal esketamine for depression is frequently limited due to resource requirements and cost. Alternative treatment models have used oral, sublingual or intranasal racemic ketamine, but optimal doses and frequency of administration remain unclear. Dosing modelled from the standard 0.5-1.0mg/kg twice weekly IV ketamine result in transient...
npj Mental Health Research
July 27, 2026
Jennifer Swainson, P. Grewal, S. Polard et al.
This scoping review maps literature for use of ketamine or esketamine with psychotherapy for depression or depressive symptoms. Forty-seven studies were identified including 4/47 (9%) randomized controlled trials, 4/47 (9%) open label trials, 27/47 (57%) observational or retrospective studies, and 12/47 (26%) individual case reports. Studies were categorized as Ketamine/Esketamine Combined with...
Psychopharmacology
July 1, 2026
Sarah Ann Smith, Haseeb Mohammad, Lik Hang N Lee et al.
Interest in psychedelic drugs has increased rapidly because of their potential therapeutic role in psychiatric disorders. Impairments in the sociocognitive skills needed to build and maintain social relationships are prominent features of many psychiatric and neurodevelopmental disorders. Emerging evidence suggests that compounds such as 3,4-methylenedioxymethamphetamine (MDMA), lysergic acid...
Psychiatry Research
May 12, 2026
Isis Lunsky, Gilmar Gutierrez, Xena Wang et al.
Postpartum Depression (PPD) is a common condition with serious consequences for both mother and baby if left untreated. Currently, few effective strategies exist for prevention of PPD. Ketamine and Esketamine are rapid acting and potent antidepressants, and emerging evidence is showing promising results for PPD. This review searched the MEDLINE, CINAHL, PsycINFO, EMBASE, and Cochrane databases,...
Expert Opinion on Drug Safety
February 19, 2026
Kyle Valentino, Kayla M Teopiz, Christine E. Dri et al.
1. Esketamine as monotherapy or adjunct to conventional antidepressants is proven efficacious in clinical trials in adults with treatment-resistant depression (TRD) and depression with high risk of...
Journal of Military, Veteran and Family Health
February 1, 2026
Ian Stefanuk, Kaitlin Chivers-Wilson, Rakesh Jetly et al.
Introduction: Comorbid conditions such as major depressive disorder, anxiety disorders, and posttraumatic stress disorder are common among Veterans, and the presence of multiple conditions requires innovative treatment approaches. The Newly Institute in Calgary, Alberta, Canada, has introduced a novel intervention combining sublingual ketamine therapy with a medically managed transdiagnostic...
The Canadian Journal of Psychiatry
October 28, 2025
Jennifer Swainson, Elisa Brietzke, Atul Khullar et al.
2 citations
There has been a renewed interest in the use of various psychedelic agents as potential therapies for multiple psychiatric conditions, including post-traumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD), to name a few. This follows the recent accumulation of evidence for ketamine pharmacotherapy and a rapid proliferation of clinics/programs...
Psychiatry and Clinical Psychopharmacology
August 11, 2025
Reinhard Janssen-Aguilar, Shakila Meshkat, Huda Al-Shamali et al.
4 citations
Posttraumatic stress disorder (PTSD) is a severe, often difficult-to-treat condition, highlighting the need for innovative therapies. Interventional treatments, including neuromodulation, rapid-acting pharmacotherapies such as intravenous ketamine (IV-KET) and esketamine (ESK), and emerging psychedelic-assisted psychotherapies, offer promising solutions. This systematic review evaluates the...
Psychiatry and Clinical Psychopharmacology
August 11, 2025
Lisa Burback, Olga Winkler, Rakesh Jetly et al.
Traditional trauma-focused psychotherapies (TFPs) were developed based on an anxiety disorder model of posttraumatic stress disorder (PTSD). However, PTSD is a more complex disorder with heterogeneous onset, presentation, trajectory, and treatment responsivity. As half of treated patients do not respond to first-line treatments, innovative therapies are emerging to improve outcomes. This...
Journal of Substance Use and Addiction Treatment
August 1, 2025
Reinhard Janssen-Aguilar, Shakila Meshkat, Ilya Demchenko et al.
12 citations
Substance Use Disorders (SUDs) involve diminished control, risky use, impaired social interactions, and physical dependence. Despite their global prevalence and burden, treatment options remain limited. Ketamine (KET), an NMDA receptor antagonist, may aid SUD treatment by modulating glutamatergic neurotransmission. This systematic review evaluates KET's role in SUD treatment. This review...
Neuroscience & Biobehavioral Reviews
June 1, 2025
Shakila Meshkat, Gunjan Malik, Richard J. Zeifman et al.
11 citations
Psilocybin, a serotonergic psychedelic, may have therapeutic benefits for Substance Use Disorders (SUDs), but its overall efficacy and safety remain uncertain. This systematic review assessed the safety and efficacy of psilocybin for SUDs through a systematic database search conducted via OVID on May 22, 2024, and summarized 26 ongoing clinical trials registered on clinicaltrials.gov. Among 16...
PLOS mental health
April 2, 2025
Marta Stuart, Ian Stefanuk, Rebecca Comeau et al.
1 citation
Ketamine is an NMDA receptor antagonist, long used for its anesthetic and pain reducing properties, but has more recently demonstrated efficacy for treating depression. Evidence is also emerging for other psychiatric indications including posttraumatic stress disorder, anxiety disorders, obsessive compulsive disorder, and to support psychotherapy. In this context, there is greater demand for...
Progress in Neuro-Psychopharmacology and Biological Psychiatry
April 2, 2025
Viktoriia Kurkova, Olga Winkler, Andrew J. Greenshaw et al.
This scoping review addresses the need to comprehensively explore the potential of psychedelic-assisted psychotherapy (PAP) to facilitate recovery from moral injury. Moral injury (MI), characterized by profound psychological distress arising from morally challenging experiences, has garnered increased attention as a complex mental health concern with significant functional sequelae, especially...
Journal of Clinical Medicine
February 20, 2025
Shakila Meshkat, Taha Malik, Jennifer Swainson et al.
3 citations
Background/Objectives: Suicide accounts for 1.4% of global deaths, and the slow-acting nature of traditional treatments for suicide risk underscores the need for alternatives. Psychedelic therapies may rapidly reduce suicide risk. This systematic review evaluates impact of psychedelic therapies on suicide-related outcomes. Methods: A systematic search of MEDLINE, Embase, PsycINFO, and...
Therapeutic advances in drug safety
2025
Gilmar Gutierrez, Gustavo Vazquez, Nisha Ravindran et al.
5 citations
Intranasal (IN) esketamine has become an effective and well-tolerated therapeutic option for the management of treatment-resistant depression within major depressive disorder (MDD-TRD). Despite these promising benefits, given the prevalence of ketamine abuse, concerns remain over the addiction liability that may be associated with esketamine treatment. The objective of this study is to assess...
Ketamine
2025
Carson Chrenek, Jennifer Swainson
Although both intranasal esketamine and intravenous ketamine have proven efficacy and tolerability in treatment-resistant depression (TRD), patient access to these treatments is often limited due to cost, availability, and/or monitoring requirements. This article is intended to provide a synthesis of the current literature with regard to the pharmacologic use of ketamine in TRD and describe its...
Psychiatry Research
October 1, 2024
Gilmar Gutierrez, Jennifer Swainson, Nisha Ravindran et al.
17 citations
Intravenous (IV) ketamine and intranasal (IN) esketamine are novel therapies to manage treatment resistant depression within major depressive disorder (MDD-TRD). This is a multi-site observational study aiming to assess the real-world effectiveness and tolerability of these novel therapies in the management of MDD-TRD. 53 patients were referred to receive IV ketamine (n = 26, 69.23 % female,...
Therapeutic Advances in Psychopharmacology
2024
Raymond Yan, Tyler Marshall, Atul Khullar et al.
11 citations
Intravenous (IV) ketamine is a rapid acting antidepressant used primarily for treatment-resistant depression (TRD). It has been suggested that IV ketamine's rapid antidepressant effects may be partially mediated via improved sleep and changes to the circadian rhythm. This study explores IV ketamine's association with changes in patient-reported sleep quality and circadian rhythm in an adult...
Frontiers in Psychiatry
2023
Carson Chrenek, Bryan Duong, Atul Khullar et al.
23 citations
Though intravenous (IV) ketamine and intranasal (IN) esketamine are noted to be efficacious for treatment-resistant depression (TRD), access to each of these treatments within healthcare systems is limited due to cost, availability, and/or monitoring requirements. IV ketamine has been offered at two public hospital sites in Edmonton, Canada since 2015. Since then, demand for maintenance...
Frontiers in Psychiatry
November 17, 2022
Brittany Chubbs, Jay Wang, S. Archer et al.
Ketamine has gained rapid popularity as a treatment option for treatment resistant depression (TRD). Though seen only in limited contexts, ketamine is a potential drug of abuse, addiction and diversion. Clinical ketamine studies to date have not systematically evaluated factors relevant to addiction risk in patients with TRD, but in treating patients with ketamine, risks of potential harms...
BMJ Open
September 1, 2022
Gustavo Vazquez, Gilmar Gutierrez, Joshua D. Rosenblat et al.
6 citations
INTRODUCTION: Esketamine is the S-enantiomer of racemic ketamine and has been approved by the Food and Drug Administration for the management of treatment resistant depression, demonstrating effective and long-lasting benefits. The objective of this observational study is to elucidate the association of intranasal (IN) esketamine with beneficial and negative outcomes in the management of...
Journal of Psychiatric Research
May 1, 2022
Tuyen T. Le, Isabel Pazos Cordero, Muhammad Youshay Jawad et al.
82 citations
While ketamine has been used clinically over the past decades, it has only been recently shown to be a promising therapy for treatment-resistant depression (TRD). However, ketamine and related dissociative agents may also be misused recreationally, creating significant concerns for abuse liability when prescribed for depression. Although the abuse potential of ketamine is widely recognized,...
JMIR Research Protocols
May 1, 2022
Gilmar Gutierrez, Joshua D. Rosenblat, Emily R. Hawken et al.
Background Intravenous (IV) ketamine and intranasal (IN) esketamine have been studied as novel alternatives to manage treatment-resistant depression (TRD). The objective of this observational pilot study is to compare the real-world effectiveness and tolerability of IV ketamine and IN esketamine in the management of unipolar TRD. Objective To compare the effectiveness (primary outcome measure)...
CNS Drugs
February 14, 2022
Jennifer Swainson, L. Klassen, Stefan Brennan et al.
42 citations
Intravenous (IV) ketamine is increasingly used off-label at subanesthetic doses for its rapid antidepressant effect, and intranasal (IN) esketamine has been recently approved in several countries for treating depression. The clinical utility of these treatments is limited by a paucity of publicly funded IV ketamine and IN esketamine programs and cost barriers to private treatment programs, as...