Frontiers in Medicine
June 12, 2026
Xiaofan Yang, Jing Qin, Wenqing Xu
Introduction This study aims to systematically evaluate, through a systematic review and meta-analysis, the effect of esketamine on postoperative negative emotions (anxiety and depression) and cognitive function in patients undergoing general anesthesia. Methods Following PRISMA guidelines, we systematically searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI to identify studies...
Perioperative medicine (London, England)
June 12, 2026
Bowen Zhang, Zhun Wang, Kaili Yu et al.
Pancreaticoduodenectomy (PD) can lead to major trauma in terms of patients' mental health, including severe postoperative depression. This study aimed to investigate the effects of supplementing patient-controlled analgesia with low-dose esketamine on postoperative depression among patients undergoing PD. Eighty patients who were scheduled for PD were randomly assigned to either the control or...
Mental Health Weekly
June 12, 2026
Valerie A. Canady
For many patients with major depressive disorder, reaching remission — not just partial response — can significantly alter the course of illness, lowering the risk of relapse and improving day‐to‐day functioning. Yet that goal remains elusive for those with treatment‐resistant depression (TRD), where repeated medication failures, comorbid conditions, and lingering symptoms complicate care. Data...
Clinics and practice
June 12, 2026
Ana María De Granda-Beltrán, Alejandro Porras-Segovia, Daniel Núñez-arias et al.
Background: Treatment-resistant depression (TRD) poses a major clinical challenge, particularly when accompanied by suicidal behavior. Intranasal esketamine has demonstrated rapid antidepressant effects in TRD, but real-world comparative evidence remains limited. Methods: We conducted a six-month naturalistic prospective cohort study in two Spanish mental health centers, including 62 TRD...
Journal of Psychiatric Research
June 12, 2026
Juliana Lima Constantino, Tobias Stephan Freimann, Jens H van Dalfsen et al.
Oral esketamine is a potentially effective and well-tolerated treatment for treatment-resistant depression (TRD). However, around 50% of TRD individuals treated with oral esketamine do not achieve response, and this variation in response may be accounted for by interindividual differences between patients. Efforts to develop effective and personalized depression treatment strategies are...
European Psychiatry
June 10, 2026
Riccardo Guglielmo, Miriam Olivola, Alberto Inuggi et al.
Esketamine has demonstrated efficacy in treatment-resistant depression (TRD), but medium-term real-world functional outcomes remain understudied. This study described 6-month depressive symptoms and functional trajectories during routine esketamine treatment, focusing on functional outcomes and remission correlates. In this prospective multicenter study, 60 patients with TRD initiating...
Fortschritte der Neurologie · Psychiatrie
June 8, 2026
Udo Bonnet, Norbert Scherbaum, Georg Juckel et al.
Introduction: Esketamine nasal spray (EN) has been approved in Germany since 2021 for the treatment of treatment-resistant depression (TRD). Historically, the development of EN resulted from the positive results of randomized clinical trials on the off-label use of subnarcotic ketamine infusions (SKI) for TRD. How effective, tolerable, and safe is off-label SKI compared to EN? Methods: Narrativ...
Journal of Affective Disorders
June 8, 2026
Dian‐jeng Li, Tien-Wei Hsu, Te-Chang Changchien et al.
Little is known about esketamine's effectiveness for patients with major depressive disorder (MDD) comorbid substance use disorders (SUD). We conducted a retrospective cohort study using the TriNetX US Collaborative Network, including adults aged ≥18 years with MDD. Three propensity-score-matched (1:1) cohorts were defined based on treatment: esketamine, antidepressant-only, and repetitive...
Journal of Affective Disorders
June 7, 2026
Lindsay L Benster, Jordan N Kohn, Benjamin Wade et al.
Repetitive transcranial magnetic stimulation (rTMS) and intranasal esketamine are FDA-approved for treatment-resistant depression (TRD), yet comparative real-world data on response trajectories and predictors of outcomes remain limited. A retrospective analysis was performed using electronic medical records from UC San Diego Health. Adults with TRD treated with rTMS (n = 279) or intranasal...
European Psychiatry
June 1, 2026
P.-M. Llorca, Ludovic Samalin, Emilie Olié et al.
Introduction: Esketamine nasal spray (ESK) was approved in 2019 in Europe for adults with Treatment-Resistant Depression (TRD), defined as inadequate response to at least two different antidepressants during the current moderate to severe depressive episode Objectives: To assess patient-reported outcomes related to symptomatology, quality of life, and occupational impairment over 12 months...
European Psychiatry
June 1, 2026
Miriam Olivola, V. Martiadis, Kevin la Monica et al.
Introduction The role of dissociation in mediating antidepressant response to intranasal esketamine remains debated. While dissociative experiences are often observed during treatment, their predictive value for clinical outcomes is uncertain. Objectives We aimed to assess whether (i) baseline dissociative traits (DES-II) and (ii) early changes in dissociation (ΔDES T0→T2) predict short-term...
European Psychiatry
June 1, 2026
V. Casati, Kevin la Monica, Mauro Angeletti et al.
Introduction Intranasal esketamine has emerged as an innovative treatment for TRD due to its rapid antidepressant effects. However, the clinical response is heterogeneous, and growing evidence suggests that comorbid personality disorders (PDs) may significantly shape treatment outcomes. Although PDs are frequently diagnosed in TRD patients, little is known about their differential influence on...
European Psychiatry
June 1, 2026
Giada Versaci, Miriam Olivola, Kevin la Monica et al.
Introduction Esketamine-induced dissociation is a transient, pharmacologically mediated alteration in consciousness, often distinct from pathological dissociation. While not required for clinical improvement, these states may engage neural circuits implicated in therapeutic change. Objectives This study explores patients’ lived experiences of dissociation as potentially meaningful transitional...
European Psychiatry
June 1, 2026
Cristina Serritella, L. Iorio, F. Ferraiuolo et al.
Introduction Intranasal esketamine provides a rapid therapeutic option for treatment-resistant depression but can induce transient blood pressure increases. The influence of psychopathological traits on these cardiovascular responses remains largely unexplored. Objectives The present study aims to investigate the acute effects of intranasal esketamine on systolic and diastolic blood pressure as...
Journal of Psychopharmacology
June 2026
Vasilios G Masdrakis, Zoe Tebbs, Vasilios Natsis et al.
Ketamine and esketamine ("es/ketamine") treatment protocols have been investigated in patients' samples with treatment-refractory anxiety disorders. We systematically reviewed publications in which es/ketamine was used to treat anxiety symptoms in the context of either Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) anxiety disorders or treatment-resistant...
European Psychiatry
June 1, 2026
L. Mana, R. Lisbino, P. Pezzella et al.
Introduction Ketamine and esketamine exert rapid antidepressant and dissociative effects, and the growing clinical use of intranasal esketamine for depression opens the possibility of large-scale electroencephalography (EEG) studies to explore their mechanisms through a non-invasive approach. However, understanding the neurophysiological basis of these effects requires a clear synthesis of...
European Psychiatry
June 1, 2026
V. Martiadis, Fabiola Raffone, Serena Testa et al.
Introduction Treatment-resistant depression (TRD) is a severe condition associated with high suicide risk and limited response to conventional antidepressants. Intranasal esketamine has shown rapid efficacy in reducing depressive symptoms and suicidal ideation. Objectives This observational study assessed the real-world effectiveness of esketamine in reducing suicidal ideation, self-harm...
European Psychiatry
June 1, 2026
O. Płaza, Robert Madejek, M. M. Dutsch-Wicherek et al.
Introduction Treatment-resistant depression (TRD), which affects about 30% of patients with major depressive disorder, emerges when patients do not respond adequately to at least two antidepressant trials of proper dose and duration. The EMA approved esketamine nasal spray, the first registered psychedelic medication, in 2019 for TRD treatment. In July 2023, Poland launched B.147, the country’s...
European Psychiatry
June 1, 2026
Nawfel Ayad, Samer Makhoul
Introduction Treatment-resistant depression (TRD) poses a significant clinical challenge, with limited evidence guiding long-term pharmacological strategies. Esketamine, a glutamatergic modulator, has demonstrated short-term efficacy in TRD, but data on its extended use in real-world settings remains scarce Objectives This study aimed to evaluate the long-term effectiveness and tolerability of...
European Psychiatry
June 1, 2026
T. Sagues, A. Barnes, C. Fernández et al.
Introduction Intranasal esketamine has emerged as an innovative option for the management of treatment-resistant depression (TRD), offering a novel mechanism of action and rapid antidepressant effects. However, evidence regarding the clinical trajectory after treatment discontinuation remains limited, raising questions about the durability of its therapeutic benefits and the optimal maintenance...