Objective: To investigate neurobiological mechanisms through which esketamine produces rapid antidepressant effects in adolescents with major depressive disorder (MDD), focusing on structural changes in the rostral anterior cingulate cortex (rACC) and associated molecular pathways. Method: A total of 49 adolescents (13-18 years of age) with DSM-5 MDD were randomized to receive intravenous...
Background: Suicidal ideation (SI) represents a clinical challenge in patients with treatment-resistant depression (TRD), and the management of this condition should be as rapid and effective as possible. Intranasal Esketamine has shown promise in patients with TRD due to its rapid onset of action on both SI and depressive symptoms. Since this medication has been recently approved, real-world...
Major depressive disorder (MDD) is a multifactorial mental health condition involving genetic, environmental, and neurobiological factors. Conventional antidepressants such as fluoxetine, a selective serotonin reuptake inhibitor, require weeks to exert therapeutic effects, whereas ketamine and esketamine act rapidly via glutamatergic modulation. These drugs may also converge on the inhibition...
Cancer patients frequently experience pain and depression, yet current guidelines address these conditions separately and do not recommend a single agent for concurrent management. Ketamine and its S-enantiomer esketamine, through N-methyl-D-aspartate receptor antagonism and glutamate modulation, may offer dual benefit. This paper examined ten clinical studies published between 2018 and 2024...
PsychoactivesDecember 24, 2025Brendan Driscoll, Shaheen E. Lakhan1 citation
Psychedelic-assisted therapy offers rapid and profound benefits for treatment-resistant psychiatric conditions but remains constrained by the need for intensive, clinic-based administration. Concurrently, advances in digital health technologies have introduced scalable tools. This systematic review evaluates the safety, efficacy, and implementation of digitally enabled psychedelic-assisted...
BACKGROUND: Elderly patients undergoing pulmonary lobectomy with incision are at a high risk for postoperative cognitive dysfunction (POCD). Intraoperative esketamine may offer potential neuroprotective benefits. This study aimed to evaluate the efficacy of intraoperative esketamine in reducing the incidence of POCD in elderly patients undergoing pulmonary lobectomy with incision. METHODS: In...
Dissociation is a complex and transdiagnostic phenomenon defined as a disruption of, or discontinuity in, the normal, subjective integration of one or more aspects of psychological functioning. Dissociation has been identified as one of the most frequently occurring adverse effects associated with the use of esketamine nasal sprays. Individuals with high trait dissociation may be at a higher...
Esketamine and ketamine are perioperative analgesics and anesthetics that have been widely adopted in clinical practice in Europe and the United States. However, their application in China remains in the early stages of exploration and implementation. Esketamine and ketamine exert their effects through multiple receptors and pathways, but primarily act through non-competitive antagonism of the...
Oral esketamine is a promising new therapy for treatment-resistant depression. However, concerns exist about interindividual pharmacokinetic variability. Genetic polymorphisms regulating the expression of ATP-binding cassette (ABC) transporters might influence bioavailability. Utilizing blood samples from a placebo-controlled trial investigating repeated, low dose oral esketamine (N = 18), we...
Psychiatry ResearchDecember 1, 2025Ahmed Z Elmaadawi, Imane Naha, Shruti Prabhudesai et al.2 citations
Treatment-resistant depression (TRD) poses significant clinical challenges, often necessitating alternative treatments such as intravenous (IV) ketamine or intranasal esketamine. This study compared the effectiveness of these modalities and examined predictors of treatment response, including comorbidity profile, prior antidepressant failures, age, and gender. A retrospective chart review was...
As a therapy for postoperative analgesia, esketamine shows relatively favorable efficacy in pain control and is associated with a lower risk of postpartum depression. However, this result is unstable. Furthermore, esketamine may increase the risk of dizziness in pregnant women aged over 30 years. Since all the experiments in this study are conducted in China, there are certain regional...
NursingDecember 1, 2025Rebecca Ann Ivory, Kathryn M. Pate, Brentyn M Jones et al.
Major depressive disorder (MDD) affects approximately 332 million people worldwide. Among those diagnosed with MDD, approximately 53% receive pharmacologic treatment, such as ketamine. Nurses must be knowledgeable about ketamine and other emerging, effective behavioral health therapies used to treat chronically depressed mood and acute suicidal ideation. This article outlines the best nursing...
Repetitive transcranial magnetic stimulation (rTMS) and intranasal esketamine are effective treatment options for treatment-resistant depression (TRD) that have not been directly compared. We aimed to compare the effectiveness of rTMS, intranasal esketamine, and pharmacotherapy for TRD using data from two randomised clinical trials (RCTs). This secondary analysis of individual patient data...
To assess the impact of low-dose intravenous esketamine on postpartum depression scores in women undergoing cesarean section. In a randomized, double-blind, placebo-controlled trial, 186 women aged 20-50 years receiving epidural anesthesia for cesarean section were divided into three groups: Group A (0.25 mg/kg esketamine intraoperatively + esketamine in PCIA), Group B (0.25 mg/kg esketamine...
Background. Major depressive disorder affects 20% of the global population, with treatment-resistant depression in 10-30% of cases. Patients with acute suicidal ideation need immediate intervention, yet conventional antidepressants require weeks to work. Esketamine offers rapid symptom reduction through NMDA receptor antagonism. Aim. To systematically review current evidence on efficacy and...
In 2019, the FDA and EMA approved intranasal esketamine for treatment-resistant depression (TRD). The current study re-evaluated its efficacy and safety. This registered report presents a systematic review and individual patient data (IPD) meta-analysis of double-blind, randomised, placebo-controlled trials (RCTs) assessing intranasal esketamine for TRD. Two reviewers independently screened...
Nearly five years of post‐approval safety data for esketamine nasal spray have uncovered no new safety concerns associated with the formulation, an analysis has found. Most adverse events occurred during the first treatment session, with incidence decreasing over the course of treatment. Results were published online Sept. 10, 2025, in the American Journal of Psychiatry .
Patients with preexisting sleep disorders face a significantly increased risk of postoperative sleep disturbance (PSD) due to heightened sensitivity to surgical stress, anesthesia, and hospital-related environmental factors. There is a critical unmet need for effective prophylactic medications to prevent PSD, as current treatment options are limited and often inadequate. This study investigated...
Ketamine and its enantiomer esketamine are NMDA receptor antagonists that have shown consistent antidepressant effects in major depression disorder (MDD). These effects suggest an active role of glutamate in the pathophysiology of depression. It has been hypothesized that acute increase of glutamate neurotransmission in the prefrontal cortex following treatment with (es)ketamine leads to...