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Effects of Esketamine on EEG temporal dynamics in patients with depression

Verina Guirguis

UNC Libraries June 21, 2026 DOI: 10.17615/b350-9s23 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational study Peer reviewed
Sample size 5
Population Participants diagnosed with major depressive disorder undergoing Esketamine treatment
Intervention Esketamine
Duration 90 minutes post administration
Topics Anxiety Depression Esketamine
Keywords Depression economics Electroencephalography Neurology Alpha finance Depressed mood Alpha-2 adrenergic receptor Anesthesia Mood disorders Temporal lobe Neuropsychiatry
Key findings 'Highness' significantly increased up to 75 minutes post-Esketamine administration, while a reduction in alpha power correlated with these mood changes.

Abstract

Esketamine is an effective rapid-acting pharmacological intervention for treatment-resistant depression. However, the temporal dynamics of underlying brain networks associated with the improvement of depressive symptoms remain elusive. This observational study seeks to delineate alteration in network activity within 90 minutes of nasal Esketamine administration, with a focus on exploring its associations with subjective drug effect and mood fluctuations. We enrolled five participants diagnosed with MDD undergoing Esketamine treatment at the UNC Chapel Hill Interventional Neuropsychiatry Unit. High-density resting-state EEG was recorded before and subsequently repeated for a total of six times up to 90 min post Esketamine administration. Prior to each recording, participants completed Visual Analogue Scales (VAS) assessing mood changes. The primary outcomes are the change in oscillatory power in canonical frequency bands and their correlation with VAS measures. In line with expected plasma peak Esketamine concentration, we observed a peak of subjective “Highness” (+31.73%) and "Happiness” (+22.75%) 15 min post administration. Linear mixed models revealed elevated “Highness” up to 75 min (all p < .035), whereas “Happiness” exhibited significant improvement up to 35 min post administration (p = .025). This temporal pattern was paralleled by a reduction of alpha power (8-12 Hz), peaking 35 min post administration (-46.36%), which was maintained up to 50 min (all p < .05). Importantly, "Highness" was significantly associated with changes in alpha power (β = -2.760, SE = 1.20, p = .034). This study offers preliminary findings regarding the acute, temporal patterns in cortical activity and mood during Esketamine treatment.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

  • Subjective 'highness' increased up to 75 minutes after esketamine and 'happiness' improved up to 35 minutes, paralleled by a reduction in alpha power.

    Synthesized

Comparable studies

Other observational and cohort studies on esketamine for anxiety, most cited first.

Study Year Design Participants
Treating bipolar depression with esketamine: Safety and effectiveness data from a naturalistic multicentric study on esketamine in bipolar versus unipolar treatment‐resistant depression Patients with treatment-resistant bipolar depression (B-TRD) and unipolar... 2023 Observational cohort n = 70
Predicting outcome with Intranasal Esketamine treatment: A machine-learning, three-month study in Treatment-Resistant Depression (ESK-LEARNING) Treatment-resistant depression patients 2023 Retrospective, multicentric, real-world study n = 149
Esketamine in treatment-resistant depression patients comorbid with substance-use disorder: A viewpoint on its safety and effectiveness in a subsample of patients from the REAL-ESK study Patients with treatment-resistant depression and a substance use disorder 2023 Observational, retrospective, multicentre study n = 26
Investigating the Effectiveness and Tolerability of Intranasal Esketamine Among Older Adults With Treatment-Resistant Depression (TRD): A Post-hoc Analysis from the REAL-ESK Study Group Adults aged 65 years or older with treatment-resistant depression 2023 Post-hoc analysis of a multicenter, retrospective, observational study n = 30
Perioperative esketamine exposure and postoperative depression and anxiety in elderly patients undergoing joint replacement surgery: a retrospective cohort study Elderly patients aged 65–80 years undergoing unilateral hip or knee joint replacement... 2026 Retrospective cohort study n = 60

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