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Efficacy and safety of esketamine for smoking cessation among patients diagnosed with lung cancer and major depression disorder: A randomized, placebo-controlled clinical trial.

Xinya Hong, Sen Xu, Gaozhong Sun, Yusi Liu, Wanqing Yi, Qiyun Hu, Wanwen Li, Junyun Liu, Fengle Wu, Ming Yu, Yifei Lou, Zhenhua Wang, Zhenzhen Xu, Caiyun Fang, Huiling Yang, Wenyuan Wang

Journal of Affective Disorders August 15, 2025 DOI: 10.1016/j.jad.2025.04.077 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Placebo-controlled Peer reviewed
Sample size 236
Population Patients diagnosed with lung cancer and major depression disorder
Intervention Esketamine
Duration 8-week intervention, 6-month follow-up
Topics Esketamine Depression
Keywords Antidepressant Major depression disorder Smoking cessation #mentalhealth depression Cancer therapy Mood disorders Psychological treatment Psychiatric care #cancertreatment lung cancer Oncology Tumor treatment #smokingcessation quit smoking Tobacco
Citations 3
Key findings Esketamine significantly improved continuous abstinence rates, depression, anxiety, cognitive function, nicotine dependence, urge to smoke, and respiratory symptoms in patients with lung cancer and major depression disorder.

Abstract

This multicenter, randomized, placebo-controlled, clinical trial was designed to investigate the efficacy and safety of esketamine (ESK) for smoking cessation. The study enrolled a sample of 236 patients diagnosed with lung cancer and major depression disorder (MDD). Treatment included intranasal delivery of ESK or placebo once a week for 8 sessions. The primary outcomes were self-reported and biologically verified continuous abstinence rates at the end of 6 months follow-up visit. The second outcomes were the severity changes of depression and anxiety. The cognitive function, the nicotine dependence, urge to smoke, respiratory symptoms and adverse events were also examined. We found that 8 sessions of ESK treatments significantly improved the self-reported (44.1 %) and biologically verified (28.8 %) continuous abstinence rates. Additionally, the severity of both depression and anxiety was also significantly relieved by ESK delivery. Furthermore, ESK was capable of improving cognitive function of the participants. Finally, the nicotine dependence, urge to smoke and smoking related respiratory symptoms of ESK group were also alleviated at the completion of follow-up. No serious adverse events were observed throughout the study. This clinical trial provides evidence that ESK treatment is efficacious and safe for quitting cigarette smoking among patients with lung cancer and MDD.

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