Intranasal esketamine use in bipolar disorder: A case report
Courtney Skriptshak, Ashley Reich
Mental Health Clinician July 1, 2021 DOI: 10.9740/mhc.2021.07.259 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Patient diagnosed with bipolar disorder without recent history of manic or hypomanic episodes |
| Interventions | intranasal esketamine mood stabilizer therapy |
| Topics | Esketamine |
| Citations | 11 |
| Key findings | Intranasal esketamine in combination with mood stabilizer therapy may be safe in a patient with bipolar disorder without recent manic or hypomanic episodes. |
Abstract
Abstract Over the past few years, intranasal esketamine has been FDA-approved for treatment-resistant depression as well as MDD with suicidal ideation. In the clinical trials leading to the recent FDA approvals, subjects with a diagnosis of bipolar disorder were excluded from participation in the trial. The manufacturer of intranasal esketamine states that it “has not been studied, and is not indicated, for patients with bipolar disorder.” Antidepressants are commonly associated with having the potential to induce rapid cycling in patients with bipolar disorder, though the mechanism is not fully understood. This case report demonstrates the potential safety of intranasal esketamine in combination with mood stabilizer therapy in a patient diagnosed with bipolar disorder without recent history of manic or hypomanic episodes.
Comparable studies
Other case reports and case series on esketamine, most cited first.
Citations in the library
Cited by 6
- Treating bipolar depression with esketamine: Safety and effectiveness data from a naturalistic multicentric study on esketamine in bipolar versus unipolar treatment‐resistant depression Bipolar Disorders January 13, 2023
- Short-term ketamine use in bipolar depression: a review of the evidence for short-term treatment management Frontiers in Psychiatry December 8, 2023
- Risk of manic switch and suicidal outcomes in bipolar depression treated with esketamine: A one-year retrospective cohort study of 2126 patients. European Neuropsychopharmacology August 6, 2025
- The role of ketamine in the treatment of treatment-resistant bipolar depression Psychiatriki December 20, 2021
- Intranasal esketamine for ECT-refractory bipolar depression: a case report Frontiers in Psychiatry July 30, 2026
and 1 more in the library
Cites 7
- 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 American Journal of Psychiatry May 21, 2019
- Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression JAMA Psychiatry June 5, 2019
- Esketamine Nasal Spray for Rapid Reduction of Depressive Symptoms in Patients With Major Depressive Disorder Who Have Active Suicide Ideation With Intent: Results of a Phase 3, Double-Blind, Randomized Study (ASPIRE II) The International Journal of Neuropsychopharmacology August 26, 2020
- Esketamine Nasal Spray for Rapid Reduction of Major Depressive Disorder Symptoms in Patients Who Have Active Suicidal Ideation With Intent The Journal of Clinical Psychiatry May 11, 2020
- Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. Psychopharmacology Bulletin April 8, 2025
and 2 more in the library