Background: Esketamine is a rapidly acting antidepressant with robust efficacy in treatment-resistant depression (TRD). Diminishing therapeutic effects and attenuated side effects have been reported after long-term use. This study aimed to investigate its long-term pharmacokinetics and factors that may contribute to reduced efficacy over time in patients with TRD by evaluating the potential...
Background Postoperative depression (POD) represents a serious complication in surgical patients, exacerbating morbidity and mortality rates while imposing a substantial economic burden on healthcare systems. Despite its widespread clinical use, the role of esketamine, an NMDA receptor antagonist with rapid antidepressant effects, remains understudied in perioperative settings. Therefore, we...
Remimazolam is a novel benzodiazepine sedative that provides effective sedation, stable haemodynamics, and minimal adverse effects during intravenous general anaesthesia. The aim of this study was to determine the 50% effective dose (ED50) of remimazolam combined with different doses of esketamine for painless gastroscopy and to evaluate the efficacy and safety of this combination. This was a...
To investigate whether continuous intravenous infusion of esketamine during surgery can improve postoperative delirium (POD) and inflammatory response in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Prospective, triple-blind, randomized controlled trial. A single tertiary center. 140 adult patients undergoing elective OPCAB. Patients in Group S (esketamine group)...
In this case report, we present a patient with treatment-resistant depression (TRD) and comorbid generalized anxiety disorder, eating disorder, post-traumatic stress disorder, and borderline personality disorder. Over a 10-year period, our case transitioned from adolescence to adulthood and received antidepressant monotherapy, adjunctive therapy with antipsychotics, lithium, or lamotrigine,...
Current NeuropharmacologyApril 7, 2025Marika Alborghetti, Luana Lionetto, Ginevra Lombardozzi et al.1 citation
Esketamine is administered intranasally in combination with at least another antidepressant in patients with treatment-resistant depression. Some of these antidepressants might affect ketamine's pharmacokinetic profile by inhibiting cytochrome-P450 (CYP450) isoforms. Our aim was to establish how different types of combined antidepressants affect serum and salivary levels of esketamine at the...
Case Report Esketamine in Geriatric Depression and Pseudodementia: A Case Study Filippo Mazzoni 1,2, Giovanni Carnevale Miacca 1,2, Alessandro Guffanti 1,2, Vassilis Martiadis 3, Benardo Maria Dell’Osso 4,5,6,7, Natascia Brondino 1,2 and Miriam Olivola 1,4 1 Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy 2 Department of Mental Health and Addiction, ASST...
Depression, a pervasive mental health condition, has increasingly been linked to neuroinflammation, as evidenced by elevated levels of pro-inflammatory markers such as TNF-α and IL-1β observed in patients, which underscores the role of inflammation in its pathophysiology. This study investigates the differential effects of S-ketamine (S-KET) and R-ketamine (R-KET) on inflammation-induced...
Treatment-resistant depression (TRD) remains a critical challenge in psychiatry, with limited effective options. Esketamine, a rapid-acting antidepressant, is usually combined with a selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI), but comparative evidence of these combinations' effectiveness in real-world settings is sparse. To determine...
European PsychiatryApril 1, 2025E. A. Ródenas Vera, S. Sabater, P. Alvarez et al.
IntroductionDepressive disorder is one of the health problems that carries the greatest burden of morbidity, with high prevalence and impact on people’s quality of life. It also affects the family environment and contributes to the social and economic burden on health systems (World Health Organization, depression, 2023). Currently, the treatment of depression has limitations and there is a...
IntroductionTreatment-resistant Depression (TRD) nowadays it is consider a public health problem. Studies had demonstrate that TRD has higher prevalence of psychiatric comorbid conditions, twice the utilization of outpatient health care resources, 3 times the number of inpatient bed-days, and 23% higher all-cause mortality. Esketamine, the S-enantiomer of ketamine, has been recently approved...
IntroductionKetamine is widely recognized for its dissociative anesthetic properties, particularly in procedural sedation and severe pain management among children, adolescents, and young adults. Despite its noted applications, research investigating ketamine’s impact on mood and suicidality within this specific demographic remains limited. This retrospective review seeks to address this gap by...
Background. Treatment-resistant depression (TRD) is a prevalent, high-burden disorder. Esketamine nasal spray (ESK-NS) has been approved for, T.R.D.; and efficacy has been observed in both clinical trials and real-world studies. However, observations integrating patients’ perspective on this treatment are limited. This multicentric Italian study explored experiences with ESK-NS in TRD patients,...
European PsychiatryApril 1, 2025Cristina Serritella, Federica Ferraiuolo, Mark Piccirillo et al.
Introduction The effectiveness of Es-ketamine therapy in the treatment of psycho-pathological symptoms is the subject of growing interest in the scientific community. Through the use of validated psychometric instruments, this study aims to delineate more precisely the mechanisms of action and clinical potential of this therapy, contributing to the advancement of knowledge in psychiatry....
To determine whether there is disproportionate reporting of hepatobiliary disorders in the United States (US) FDA Adverse Event Reporting System (FAERS) for individuals prescribed ketamine or esketamine. We identified Medical Dictionary for Regulatory Activities (MedDRA) terms in the FAERS related to hepatobiliary disorders. Formulations of ketamine and esketamine were evaluated for the...
Patients with treatment resistant depression (TRD) experience a greater negative impact on their functioning and productivity at home and in the workplace versus treatment-responsive patients. Here, we report the effects of esketamine nasal spray (NS) versus quetiapine extended release (XR) on functioning, work productivity and activity impairment. ESCAPE‑TRD (NCT04338321) was a 32-week...
CytotechnologyApril 1, 2025Jianjun Ouyang, Weiqiang Xiao, Di Wu et al.8 citations
The use of tourniquets (TQ) during the total knee arthroplasty (TKA) induced ischemia-reperfusion (I/R) injury in the limb, resulting in the release of inflammatory cytokines and reactive oxygen species (ROS), therefore leading to myocardial damage. This study aimed to investigate the effects and molecular mechanism of Esketamine on myocardial injury (MI) caused by TQ-induced I/R injury. A...
To determine whether intraoperative low-dose esketamine ameliorates depression in women having breast cancer surgery. A prospective single-center double blind randomized placebo-controlled trial. Perioperative period, operating room, post anesthesia care unit and hospital ward. 108 women 18-65 years old who were scheduled for elective breast cancer surgery. All had preoperative depressive...
Common cognitive impairment in the elderly may be aggravated by the anesthetic propofol, whereas the mammalian target of rapamycin protein (mTOR)-brain-derived neurotrophic factor (BDNF) pathway and autophagy regulation play a key role in neuroprotection. In this study, we investigated whether esketamine can improve propofol-induced cognitive impairment in aged rats by affecting these...
This research sought to determine the influence of esketamine (ESK) on hypoxia/reoxygenation (H/R) injury in cardiomyocytes by blocking autophagy via the transient receptor potential vanilloid type 1 (TRPV1)/ Ca2+/ calmodulin-dependent protein kinase β (CaMKKβ)/ adenosine monophosphate (AMP)-activated protein kinase (AMPK)/ mammalian target of rapamycin (mTOR) pathway. H9c2 cardiomyocytes were...