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Efficacy of Intravenous Racemic Ketamine on Global Severity and Individual Symptoms of Depression

Rachel Landrum, Amanda M. Raines, Philip D. Harvey, Michael Banov, Kevin G. Saulnier, Michelle B. Moore

Journal of Clinical Psychopharmacology September 25, 2025 DOI: 10.1097/jcp.0000000000002060 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Population Patients with treatment-resistant depression
Intervention Maintenance intravenous racemic ketamine therapy
Topics Ketamine Depression Esketamine
Keywords Depression economics Suicidal ideation Rating scale Appetite Randomized controlled trial Anesthesia Major depressive episode Disturbance geology
Citations 1
Key findings Maintenance intravenous racemic ketamine therapy produced significant, persistent, and broad efficacy for treatment-resistant depression, with suicidal ideation and depressed mood showing the largest improvements and appetite disturbance the least.

Abstract

Maintenance intravenous racemic ketamine therapy demonstrated significant, persistent, and broad efficacy for treatment-resistant depression as demonstrated by reductions in Montgomery-Åsberg Depression Rating Scale and Patient-Health Questionnaire-9 total scores and equivocal changes in every item on both rating scales. The magnitude of change in individual items was similar to that of previous randomized trials, with suicidal ideation and depression demonstrating the largest response and appetite disturbance the least.

Comparable studies

Other randomized controlled trials on ketamine for depression, most cited first.

Study Year Design Participants
Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial Patients with treatment-resistant major depression experiencing a major depressive episode 2013 Randomized controlled trial n = 73
Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study Adults with moderate to severe nonpsychotic depression and a history of nonresponse to... 2019 Phase 3, double-blind, active-controlled, multicenter randomized controlled trial n = 227
Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression Adults with treatment-resistant depression who achieved stable remission or stable... 2019 Phase 3, multicenter, double-blind, randomized withdrawal study n = 297
Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression Adults with DSM-IV-TR diagnosis of major depressive disorder and history of inadequate... 2017 Phase 2, double-blind, doubly randomized, delayed-start, placebo-controlled study n = 67
Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study Depressed patients at imminent risk for suicide 2018 Randomized controlled trial n = 68

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