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Emerging Clinical Applications of Ketamine and Esketamine Across Psychiatric Disorders.

Rachel Fremont, Marcella Corwin, Greta Kandel, Esha Talati, Jakub Denkiewicz, Rae L Sustana, Keren Bachi, Adriana Feder

Focus (American Psychiatric Publishing) April 1, 2026 DOI: 10.1176/appi.focus.20250046 (opens in new tab) via PubMed

Summary

AI-generated from the abstract

This review describes recent advances in the use of ketamine and esketamine for depression and other psychiatric disorders, including the FDA approval of intranasal esketamine for treatment-resistant and suicidal depression. It covers new research on novel treatment targets and emerging evidence on ketamine's potential as a prophylactic intervention. The authors also discuss key outstanding issues and limitations of current ketamine treatment, such as uncertainties about long-term efficacy and safety. The review synthesizes developments over the past 25 years, highlighting the rapid expansion of ketamine treatment services for off-label management of various conditions.

Study at a glance

Characteristics Review Peer reviewed
Topics Depression Esketamine Ketamine
Keywords Academic psychiatry Antidepressants
Key finding Argues that ketamine and esketamine have expanded treatment options for depression and other psychiatric disorders, but outstanding issues and limitations remain.

Abstract

Over the past 25 years, the field of psychiatry has seen a rapid expansion of ketamine treatment services offered for the off-label management of depression, anxiety, and other psychiatric disorders as well as the U.S. Food and Drug Administration's approval of intranasal esketamine, the S-enantiomer of ketamine, for treatment-resistant depression and suicidal depression. In this review, the authors describe recent advances in the use of ketamine and esketamine for the treatment of depression and other psychiatric disorders, new research on novel treatment targets, and emerging evidence about ketamine's potential as a prophylactic intervention. Key outstanding issues and limitations of current ketamine treatment also are discussed.

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