Rapid clinical and EEG microstate changes 24 h after intranasal esketamine in major depressive disorder with suicidal ideation: a prospective paired study.
Abstract Background: Anhedonia, a prominent symptom of major depressive disorder (MDD), severely impairs patients' quality of life and is challenging to treat. Although esketamine has shown potential in treating anhedonia in adult treatment-resistant MDD, its effects on adolescents remain under-explored. Methods: In this study, a prospective, randomized, double-blind, controlled trial was...
Background and aimFunctional neurological disorder (FND) is a common and disabling condition for which effective treatments remain limited. Clinical outcomes are often variable, particularly in chronic and comorbid presentations. Ketamine and esketamine are increasingly used across a range of neuropsychiatric conditions. This review aimed to synthesise the existing evidence regarding their use...
Esketamine nasal spray (NS) is an established treatment for patients with treatment resistant depression (TRD). To further optimise real-world outcomes, consensus is needed regarding strategies to enhance patient outcomes and decision-making factors for pivotal timepoints in esketamine NS treatment. This modified Delphi panel (3 rounds) established expert consensus (≥80% agreement) from 30...
Zenodo (CERN European Organization for Nuclear Research)July 17, 2026Bartosz Niciński, Magdalena Kloc, Ewa Wiench, Natasza Millan, Aleksandra Blicharz, Wojciech Kozdraś, Lidia Kozaczko, Gabriela Szewczyk, Elżbieta Bukowczan, Alicja Zając, Damian Broda, Alicja Benecka
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Major depressive disorder is a highly burdensome psychiatric condition worldwide, and many patients do not achieve full remission after standard monoaminergic antidepressant treatment. This has contributed to growing interest in rapid-acting antidepressant interventionstargeting neurobiological pathways beyond traditional serotonin, norepinephrine, and dopamine mechanisms. This review...
Ketamine and its enantiomer esketamine are efficacious in 30-35% of the patients with treatment-resistant depression (TRD). Increased serum brain-derived neurotrophic factor (BDNF) following treatment has been proposed as a potential biomarker of antidepressant response. This is based on studies evaluating single intravenous ketamine treatment. BDNF expression at different treatment schedules...
In acute trials of intravenous and intranasal ketamine/esketamine, the rapid anti-suicidal effect appears to be at least partly independent of the overall antidepressant response. That question has, to our knowledge, never been examined in a real-world esketamine cohort followed for six months, nor in a sample enriched for comorbid borderline personality disorder (BPD), a population excluded...
Background and Purpose: Ketamine has emerged as a promising treatment candidate for alcohol use disorder (AUD), yet whether its S- and R-enantiomers differentially regulate ongoing binge-like alcohol self-administration remains unknown. We compared the acute and repeated effects of S- and R-ketamine in a chronic binge-like, front-loaded operant alcohol self-administration paradigm. Experimental...
Research SquareJuly 9, 2026Samuel Westenhöfer, Yamina Ehrt, Barbora Provaznikova et al.
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Abstract Background : Treatment-resistant depression (TRD) is associated with substantial clinical and socioeconomic burden. Intranasal esketamine has shown efficacy for TRD in clinical trials and real-world studies. However, evidence on optimal maintenance scheduling is limited. We therefore investigated whether two maintenance schedules differing in their inter-dose intervals were associated...
Frontiers in PsychiatryJuly 9, 2026Patrice A. Bellanti, Jordan Lewis, Brian Seifferth et al.
Introduction Intravenous (IV) ketamine and intranasal esketamine are NMDA receptor antagonists used for treatment-resistant depression (TRD). Both have demonstrated efficacy in controlled trials, but observational evidence from real-world community settings is limited. Methods We conducted a single-center retrospective cohort study of adults aged 18 to 65 receiving induction therapy for TRD...
Background: Postoperative depressive symptoms may impair recovery and quality of life in patients undergoing breast cancer surgery. Esketamine has shown potential antidepressant and analgesic effects in the perioperative setting. This meta-analysis evaluated the efficacy and safety of perioperative esketamine for postoperative depressive symptoms in patients undergoing breast cancer surgery....
Annals of medicineJuly 3, 2026Zheping Chen, Yaozhu Wang, Peilin Cong et al.
Patients undergoing acoustic neuroma (AN) surgery often experience postoperative negative emotions, including anxiety, depression, and immune function suppression. This trial evaluated whether perioperative sub-anesthetic esketamine improves early postoperative negative emotions and immune function. In this single-center, double-blind, randomized trial, 84 patients scheduled for AN surgery were...
Treatment-resistant depression (TRD) remains a major clinical challenge. Intranasal esketamine, used adjunctively with an oral antidepressant, has been evaluated in randomized trials, but uncertainty persists regarding the magnitude and consistency of benefit, durability, and key harms. This systematic review and meta-analysis included randomized controlled trials comparing intranasal...
Objective This study evaluated whether intramuscular (IM) ketamine is non‐inferior to intranasal (IN) esketamine for treatment‐resistant depression (TRD) and assessed differences in safety and healthcare costs. Methods In a retrospective, observational sequential cohort at the VA San Diego, 179 Veterans with TRD received eight treatments of either IN esketamine ( n = 89) or IM ketamine ( n =...
Objective To investigate the effects of sub-anesthetic dose esketamine on oxidative stress markers and postoperative delirium(POD)in patients undergoing laparoscopic radical resection for colorectal cancer, so as to provide a reference for the selection of clinical anesthesia regimens. Methods A total of 201 patients who underwent radical resection for colorectal cancer at Taizhou People 's...
Treatment-resistant depression (TRD) is associated with severe depression, low quality of life (QoL) and reduced work productivity, which may increase risk of relapse, suicide and suboptimal response to treatment. Esketamine nasal spray plus a newly-initiated oral antidepressant (esketamine+OAD) has been shown to improve depression symptoms, QoL and productivity in patients with TRD; however...
ABSTRACT: Introduction Ketamine and esketamine have reemerged as promising interventions for treatment-resistant depression (TRD), yet debate persists regarding the clinical relevance of acute dissociative experiences. This secondary exploratory analysis examined the relationship between dissociative experiences induced by subcutaneous esketamine and antidepressant response in patients with...
Neuroinflammation, particularly Toll-like receptor 4 (TLR4)-mediated signaling, plays a critical role in the pathophysiology of depression. This study aimed to investigate the mechanisms by which S-ketamine (S-ket) and S-hydroxynorketamine (S-HNK) modulate TLR4 and peroxisome proliferator-activated receptor alpha (PPARα) signaling in the prefrontal cortex (PFC) to exert antidepressant effects....
Introduction Treatment-resistant major depressive disorder with high-risk suicidal ideation is a psychiatric emergency that requires rapid and effective intervention. Although intranasal esketamine and intermittent theta-burst stimulation (iTBS) are time-efficient therapeutic options, clinical reports describing their combined use in an accelerated inpatient schedule are limited, particularly...