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Addressing diversity gaps in esketamine clinical trials: a registry-based cross-sectional analysis of sex, race and ethnicity.

Damian Swieczkowski, Aleksander Kwaśny, Michal Pruc, Lukasz Szarpak, Wiesław Jerzy Cubała

International journal of psychiatry in clinical practice June 1, 2026 DOI: 10.1080/13651501.2026.2622532 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Registry-based cross-sectional analysis Peer reviewed
Sample size 5,116
Population Participants in interventional esketamine trials with results posted on ClinicalTrials.gov
Topics Depression Esketamine
Keywords Clinical trial Ethnicity Race
Registration NCT02493868
Key findings Esketamine clinical trials show significant racial and ethnic disparities, with underrepresentation of racial and ethnic minority groups.

Abstract

To explore sex, racial and ethnic disparities in esketamine clinical trials for mental health disorders registered on ClinicalTrials.gov. We conducted a registry-based cross-sectional analysis of interventional esketamine trials with results posted on ClinicalTrials.gov (cut-off date: 10 February 2025). Using predefined eligibility criteria, two investigators independently extracted and verified trial-level data on sex, race, ethnicity and site locations as reported in the registry. Among 13 eligible trials (n = 5116), women constituted 62.9% of participants, while men comprised 37.1%. The racial distribution included White (69.08%), Asian (13.31%), Black or African American (3.60%), and American Indian or Alaska Native (0.08%). Native Hawaiian or Other Pacific Islander participants accounted for only 0.04%. Hispanic or Latino representation ranged from 10.57% to 11.02% due to discrepancies in results reporting in trial NCT02493868. Esketamine clinical trials demonstrate significant racial and ethnic disparities, with underrepresentation of racial and ethnic minority groups. Regulatory efforts to improve diversity must lead to more effective recruitment for fair representation in future research.

Comparable studies

Other cross-sectional and survey studies on esketamine for depression, most cited first.

Study Year Design Participants
A Real-World Study on the Use, Effectiveness, and Safety of Esketamine Nasal Spray in Patients with Treatment-Resistant Depression: INTEGRATE Study. Adults aged 18-74 years with treatment-resistant depression in Spain 2025 Observational, cross-sectional, retrospective study n = 196
Mental health professionals' perspective on the use of esketamine in treatment-resistant depression and their motivation to adopt it: a Saudi cross-sectional study. Psychiatrists (of all levels, including those in training) across Saudi Arabia 2026 Cross-sectional study n = 223
Characteristics of patients with major depressive disorder eligible for and prescribed esketamine, treatment outcomes and physician experiences: a physician and patient survey in the United States. Patients with treatment-resistant depression (TRD) or major depression with acute... 2025 Cross-sectional survey n = 914
The perspectives of patients with depression toward esketamine, and the influence of their medication adherence on their viewpoints: a Saudi cross-sectional study. Adults with depression 2025 Cross-sectional study n = 283
Is approving esketamine as an antidepressant for treatment resistant depression associated with recreational use and risk perception of ketamine? Results from a longitudinal and cross-sectional survey in nightlife attendees. UK residents aged 18-34 who attended at least 6 electronic music events in the past year 2022 Longitudinal observational study with a cross-sectional sample n = 2,415

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