Treatment-resistant depression (TRD) presents substantial clinical challenges, particularly in patients with Alzheimer's disease (AD) and older adults experiencing late-life depression. Traditional monoaminergic therapies often fail in this population due to neurodegenerative changes that impact receptor dynamics and neurotransmitter systems. Emerging evidence suggests that N-methyl-D-aspartate...
Psychiatric ServicesJune 25, 2025Michael Liu, Rachel Branning, Austin Lee et al.2 citations
This study sought to investigate racial-ethnic disparities in the utilization of intravenous ketamine and intranasal esketamine therapy for major depressive disorder. The TriNetX platform was used to identify 861,179 patients diagnosed as having moderate-to-severe recurrent major depressive disorder between January 2019 and October 2024. Patients were divided into non-Hispanic White,...
Dissociative symptoms are commonly observed in a substantial minority of patients with Post-Traumatic Stress Disorder (PTSD) and during the first administration of esketamine for the treatment of Treatment-Resistant Depression (TRD). We examine differences in the number and pattern of dissociative symptoms (depersonalization, derealization, dissociative amnesia, identity fragmentation) reported...
According to recent research, esketamine may reduce the incidence of postpartum depression (PPD) risk following cesarean delivery. To further assess this potential benefit, a meta-analysis was conducted. Embase, Web of Science, the Cochrane Library, and PubMed were searched from inception through March 2025. Meta-analysis was performed using random-effects models to calculate risk ratios (RRs)...
Aim: Estimate the cost-per-remitter with esketamine nasal spray plus an oral antidepressant (ESK NS + OAD) versus quetiapine extended release plus an oral antidepressant (QTP XR + OAD) among adults with treatment-resistant depression (TRD). Materials & methods: An Excel-based model was developed to estimate the cost-per-remitter for ESK NS + OAD and QTP XR + OAD from the perspective of a US...
The rates of relapse and suicide risk are higher in treatment-resistant depression (TRD) vs non-treatment-resistant major depressive disorder. Even among patients with TRD who initially respond, the majority (70%) relapse within 6 months. To evaluate the long-term safety and efficacy of esketamine nasal spray, combined with an oral antidepressant, in patients with TRD. Phase 3, open-label,...
The N-methyl-D-aspartate receptor antagonist ketamine has found broad application in the field of psychiatry. Due to its rapid antidepressant and anti-suicidal properties, it is used as a treatment for major depressive disorder. Furthermore, ketamine evokes dissociative and psychotropic states, which allows the modeling of schizophrenic symptoms. The thalamus, a main target for ketamine's...
Despite affecting millions worldwide, major depressive disorder (MDD) remains a therapeutic challenge, with approximately one-third of patients failing to respond to standard treatments. The need for innovative, molecularly driven therapies has turned attention to ketamine and its enantiomers. While S-ketamine is clinically approved for treatment-resistant depression (TRD), it has various...
PharmacopsychiatryJune 2, 2025Ludovic C Dormegny-Jeanjean, Suzie Lenoir, Ilia Humbert et al.1 citation
Ketamine and esketamine (ESK) offer new treatment options for resistant depression. Unlike traditional antidepressants, they can be used in combination with non-selective monoamine oxidase inhibitors (NS-MAOI) without the risk of serotonergic syndrome. However, potential sympathomimetic synergy may lead to elevated blood pressure (BP). This series investigates whether cardiovascular parameters...
Results of a systematic review and meta‐analysis suggest that esketamine has only modest efficacy in the treatment of adults with treatment‐resistant depression, with initial improvement diminishing after the first few days. The results also suggest no effect of esketamine on suicidality.