Esketamine for Treatment-Resistant Depression: A Case Series and Literature Review.
Muhammad Abbas, David B Adams, Jack Noto, Renzmark D Vallesteros, Talitha West
Cureus September 2025 DOI: 10.7759/cureus.92165 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report series with literature review Peer reviewed |
|---|---|
| Sample size | 4 |
| Population | Patients with treatment-resistant depression who had failed electroconvulsive therapy (ECT) at a single Hackensack-Meridian care center |
| Intervention | Esketamine |
| Topics | Depression Esketamine |
| Keywords | Case report series Literature review |
| Key findings | Among four patients with treatment-resistant depression who had failed ECT, three experienced significant symptom improvement with esketamine, but only one achieved effective long-term treatment, with side effects limiting the others. The authors conclude that esketamine is a viable alternative for some patients with TRD, including those who have failed ECT. |
Abstract
Management of treatment-resistant depression (TRD) is complex and frustrating for patients, requiring several treatment courses before (or without) achieving remission. This investigation aims to highlight and analyze real-world instances of using esketamine for patients with TRD who have failed electroconvulsive therapy (ECT). Four case reports from a single Hackensack-Meridian care center are described in detail. They, along with a literature review, were then used to drive a narrative discussion on the potential of esketamine as a TRD therapy. Of the four cases analyzed, three patients experienced significant improvement in symptoms. However, largely due to side effects, only one case resulted in effective long-term treatment using esketamine. Given that all four patients previously failed ECT, these results are encouraging. Even a humble success rate may inspire hope in a patient population that is largely considered intractable using current methodology. This study found that esketamine is a viable alternative for some patients suffering from TRD. This even remains true in some of our patients who have failed ECT - one of the more effective, more aggressive therapies for TRD.
Comparable studies
Other case reports and case series on esketamine for depression, most cited first.