Objective: Both intravenous (IV) racemic ketamine and intranasal (IN) esketamine have emerged as rapid-acting antidepressants for treatment-resistant depression (TRD) and are increasingly used in clinical settings. Relatively few studies, however, have compared these interventions in larger, naturalistic cohorts. This study was conducted to assess the comparative efficacy and rapidity of...
This is the first systematic review to assess the effectiveness of ketamine/esketamine in this cohort. Our findings suggest that ketamine/esketamine may be useful in improving symptoms of depression, in those with comorbid borderline personality disorder. Limited study data are available; however, given case reports of suicidal ideation and self-harm following treatment cessation, as well as...
Background: Treatment-resistant depression (TRD) has a poor response to clinical treatment. Patients with TRD do not respond adequately to standard antidepressants. Even after receiving a full dose and sufficient duration of combined antidepressant therapy, significant improvement is still difficult to achieve. At present, electroconvulsive therapy (ECT) remains a clinically effective method...
CureusSeptember 2025Muhammad Abbas, David B Adams, Jack Noto et al.
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...
Treatment-resistant depression (TRD) remains a major clinical challenge, affecting nearly one-third of individuals with major depressive disorder (MDD) who fail to respond to standard antidepressant therapies. Esketamine, the S-enantiomer of ketamine, has emerged as a novel therapeutic option. Esketamine, initially introduced as an add-on therapy, has more recently also received recognition for...
INTRODUCTION Dysfunction in amygdala networks has been implicated in major depressive disorder (MDD). Pharmacological treatments, such as esketamine and sertraline, are believed to exert their antidepressant effects by modulating amygdalar activity. This study aimed to investigate the relationship between changes in dynamic functional connectivity (dFC) within amygdala subregions and treatment...
INTRODUCTION Treatment-Resistant Depression (TRD) remains a major challenge in the management of Major Depressive Disorder (MDD). Esketamine, the S-enantiomer of ketamine and a glutamatergic modulator, has been approved by the FDA and EMA for TRD in 2019. Beyond its rapid antidepressant effects, esketamine may enhance neuroplasticity, facilitating the reconnection with emotional and cognitive...
Treatment-resistant depression (TRD) remains a relevant issue in psychiatric practice, driving the exploration of innovative therapeutic alternatives. Ketamine and its enantiomer, esketamine, are emerging as treatments known for their effectiveness as rapid-acting antidepressants. Although previous comparative studies have highlighted some differences in their effects, they did not concurrently...
Intranasal (IN) esketamine represents a novel add-on treatment for treatment-resistant depression (TRD) with reported favourable effects on insomnia. IN esketamine treatment might similarly reduce the incidence of insomnia as an adverse event (AE). The present meta-analysis therefore investigated whether IN esketamine relative to placebo is associated with a lower incidence of insomnia as an AE...
Esketamine has been shown to produce a major antidepressant response in patients with treatment-resistant depression (TRD). We evaluated the factors associated with achieving remission in these individuals. The study was carried out across four psychiatry departments in Madrid, Spain. Patients aged over 18 years were included if they received esketamine as an augmentation treatment for TRD....