IN Esketamine and IV Ketamine: Results of a multi-site observational study assessing the effectiveness and tolerability of two novel therapies for treatment-resistant depression.
Gilmar Gutierrez, Jennifer Swainson, Nisha Ravindran, Raymond W. Lam, Peter Giacobbe, Ganapathy Karthikeyan, Annette Kowara, André Do, Anusha Baskaran, Sean Michael Nestor, Melody J Y Kang, Aleksandar Biorac, Gustavo Vazquez
Psychiatry Research October 1, 2024 DOI: 10.1016/j.psychres.2024.116125 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Sample size | 53 |
| Population | Patients with treatment-resistant major depressive disorder |
| Interventions | IV ketamine IN esketamine |
| Topics | Depression Esketamine Ketamine |
| Keywords | Antidepressant effect Depressive symptoms Psychopharmacology Real-world clinical data Suicidal ideation Treatment response Depression treatment Ketamine therapy Clinical research Antidepressant medications Mental health interventions |
| Citations | 17 |
| Key findings | Both IV ketamine and IN esketamine significantly reduced depressive symptoms and suicidal ideation with mild, transient side effects. |
Abstract
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, 52.81 ± 14.33 years old) or IN esketamine (n = 27, 51.85 % female, 43.93 ± 13.57 years old). Treatment effectiveness was assessed using the Montgomery and Åsberg Depression Rating Scale (MADRS) for depression severity and item 10 of the MADRS for suicidal ideation (SI). Tolerability was assessed by systematically tracking side effects and depersonalization using the 6-item Clinician administered dissociative symptom scale (CADSS-6). The data was analyzed using descriptive statistics, risk ratio and effect size. Both IV ketamine and IN esketamine significantly reduced depressive symptoms and suicidal ideation by treatment endpoint. Patients receiving IN esketamine, and patients receiving IV ketamine had a similar risk of developing side effects. All side effects reported were mild and transient. These results suggested that both IV ketamine and IN esketamine are effective in the management of depressive symptoms and were well tolerated. Therefore, the results of this study could serve to inform clinical practice.
Comparable studies
Other observational and cohort studies on esketamine for depression, most cited first.
Citations in the library
Cited by 14
- Intravenous ketamine versus esketamine for depression: a systematic review and meta-analysis. Therapeutic Advances in Psychopharmacology 2025
- Esketamine/Ketamine: Dual‐Action Mechanisms and Clinical Prospects beyond Anesthesia in Psychiatry, Immunology, and Oncology Advanced Science December 14, 2025
- Abuse liability for esketamine in a cohort of patients undergoing an acute treatment course to manage treatment-resistant depression: a secondary analysis of an observational study in real-world clinical practicee. Therapeutic advances in drug safety 2025
- Patients’ Voices on Ketamine for Treatment-Resistant Depression: A Narrative Review of Qualitative Perspectives Journal of Clinical Medicine December 25, 2025
- Use of Psychedelic Agents in Older Adults with Treatment-Resistant Major Depressive Disorder: What the Evidence Shows. Drugs Aging June 24, 2025
and 9 more in the library
Cites 26
- Mechanisms of Ketamine Action as an Antidepressant Molecular Psychiatry March 13, 2018
- Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation American Journal of Psychiatry March 17, 2021
- Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry 2018
- Single, Repeated, and Maintenance Ketamine Infusions for Treatment-Resistant Depression: A Randomized Controlled Trial. American Journal of Psychiatry March 29, 2019
- Comparative efficacy of racemic ketamine and esketamine for depression: a systematic review and meta-analysis Journal of Affective Disorders September 23, 2020
and 21 more in the library