April 21, 2026
Samuel T. Wilkinson
When a patient relapses after tapering off ketamine or esketamine, consider restarting an index course (twice weekly for a few weeks, then spread out). With ketamine or esketamine, dysphoric reactions occur in roughly 1 in 200-300 treatments. Many resolve with supportive care alone; others require a short-acting benzodiazepine such as lorazepam. For esketamine sessions, have patients fast for...
Scientific Reports
April 21, 2026
Rong Ding, Daojie Wang, Guoxin Wang et al.
Elderly colorectal cancer (CRC) patients face high risks of postoperative depression state, inadequately addressed by opioid-based analgesia. Esketamine, an NMDA receptor antagonist with rapid antidepressant effects, offers potential benefits but lacks evidence in this population. This double-blind RCT enrolled 99 elderly (≥ 65 years) CRC resection patients, randomized to three postoperative...
Pharmaceuticals
April 16, 2026
Maria Marmureanu, Mariana Valy Besoiu, Vlad Dionisie et al.
Background/Objective: A substantial proportion of patients with obsessive-compulsive disorder (OCD) does not respond adequately to first-line treatments such as selective serotonin reuptake inhibitors and cognitive-behavioral therapy. OCD has traditionally been conceptualized as a serotonergic disorder. However, emerging evidence suggests that glutamatergic dysfunction plays an important role....
BMC Anesthesiology
April 15, 2026
Wei Tan, Yuanyuan Gao, Dan Su et al.
Depressive symptoms frequently afflict individuals with Parkinson’s disease (PD). The current study was consequently conducted to determine the efficacy of low-dose intravenous esketamine in managing postoperative depressive symptoms, thereby exploring its potential mechanisms of action in PD patients subjected to non-intracranial surgery. In this randomized, double-blind, placebo-controlled...
Journal of Affective Disorders
April 15, 2026
Gia Han Le, Sabrina Wong, Danica E. Johnson et al.
4 citations
Ketamine and esketamine exhibit rapid antidepressant effects in persons with treatment-resistant depression (TRD) and bipolar depression (TRBD). However, the synaptic mechanisms governing dose, frequency, and durability of response remain unclear. This review aims to evaluate the dosing parameters, including minimum dose and optimal dosing intervals, that reliably induce or maintain long-term...
Journal of Affective Disorders
April 15, 2026
Jen-Ping Chen, Chih-Wei Hsu, Yi-Ting Chen et al.
Repetitive transcranial magnetic stimulation (rTMS) and esketamine are FDA-approved treatments for treatment-resistant depression (TRD), yet head-to-head comparative effectiveness data remain limited. Our study compared the effectiveness and safety profiles of rTMS versus esketamine in adults with TRD. This cohort study used target trial emulation with 1:1 propensity score matching on 50...
Translational Psychiatry
April 10, 2026
Ting-Hui Liu, Hong-Shiang Shen, Jheng-Yan Wu et al.
1 citation
This study aimed to evaluate the long-term effectiveness and safety of esketamine in adults with Major depressive disorder (MDD), focusing on suicide-related events, all-cause mortality, and major adverse cardiovascular events (MACEs). This target-trial simulation used the TriNetX Global Collaborative Network. Adults (≥ 18 years) with MDD who received either esketamine or a conventional...
Reviews on recent clinical trials
April 7, 2026
Ritika Saun, Aakriti Garg, Mohd Ashif Khan
Most of the Major Depressive Disorder (MDD) patients experience Treatment-Resistant Depression (TRD), wherein standard pharmaceutical and psychological interventions fail to provide adequate symptom relief. This systematic review and meta-analysis investigated the efficacy and safety of intranasal esketamine for rapid symptom relief in adults with TRD. The search strategy adhered to PRISMA...
Yixue xinzhi zazhi
April 2, 2026
Yao Wenzhuang, Zhang Hanyun, Liu Suman et al.
Objective To systematically evaluate the efficacy and safety of Esketamine on postpartum depression (PPD) in cesarean section women.Methods Databases including PubMed, Embase, Web of Science, The Cochrane Library, CBM, CNKI, WanFang and VIP were searched from inception to March 2025 for RCTs investigating the impact of Esketamine on PPD in cesarean section parturients. RevMan 5.4 and Stata 18.0...
Biomolecules
April 2, 2026
Nikola Balic, Gordana Nedic Erjavec, Marcela Konjevod et al.
Major depressive disorder (MDD) is associated with complex metabolic alterations. In this study, we applied a multiplatform metabolomics approach (GC-MS and LC-MS) to characterize the plasma extracellular vesicle (EV) metabolome in healthy controls (N = 50), responsive MDD patients (N = 60), and patients with treatment-resistant depression (TRD; N = 65). Longitudinal analyses were performed...
FOCUS: The Journal of Lifelong Learning in Psychiatry
April 1, 2026
Thomas Kun Pak, Stephen Kimatian, Graham J Emslie et al.
Ketamine is a well-established anesthetic agent that is gaining increasing recognition for its diverse therapeutic applications, including the management of chronic pain, refractory status epilepticus, major depressive disorder, and suicidality. Although it has been used clinically since the 1960s, multiple clinical trials with ketamine and esketamine in adults and pediatric populations are...
FOCUS: The Journal of Lifelong Learning in Psychiatry
April 1, 2026
Rachel Fremont, Marcella Corwin, Greta Kandel et al.
Over the past 25 years, the field of psychiatry has seen a rapid expansion of ketamine treatment services offered for the off-label management of depression, anxiety, and other psychiatric disorders as well as the U.S. Food and Drug Administration's approval of intranasal esketamine, the S-enantiomer of ketamine, for treatment-resistant depression and suicidal depression. In this review, the...
FOCUS: The Journal of Lifelong Learning in Psychiatry
April 1, 2026
Naim Zaki, Li Nancy Chen, Rosanne Lane et al.
Patients with treatment-resistant depression (TRD) have higher rates of relapse and pronounced decreases in daily functioning and health-related quality of life compared to patients with major depressive disorder who are not treatment-resistant, underscoring the need for treatment choices with sustained efficacy and long-term tolerability. Adults with TRD who participated in ≥1 of 6 phase 3...
Clinical and Translational Science
April 1, 2026
Matthijs W Van Hoogdalem, Dong-Jing Fu, Wayne C. Drevets et al.
Major depressive disorder (MDD) imposes a substantial burden worldwide, with treatment-resistant depression (TRD) and major depressive disorder with acute suicidal ideation or behavior (MDSI) representing two of the most severe clinical challenges. Conventional antidepressants often require several weeks to exert benefit, leaving patients symptomatic and at risk during this delay. Esketamine...
PLoS Medicine
April 1, 2026
Yifan Li, Vivien Kin Yi Chan, Mark Jit et al.
Treatment-resistant depression (TRD), defined as failure to respond to at least two adequately administered antidepressant (AD) regimens, imposes major clinical and economic burdens. Esketamine nasal spray offers rapid antidepressant clinical effects, yet previous evaluations compared it only with unrealistic comparators such as AD monotherapy. This study assessed the cost-effectiveness of...
Journal of Cerebral Blood Flow & Metabolism
April 1, 2026
Daphne E Boucherie, Liesbeth Reneman, Jan Booij et al.
Neuroimaging techniques offer valuable insights for understanding pharmacological treatment effects in neuropsychiatric disorders. Here, we present a novel approach that simultaneously assesses hemodynamic and neurometabolic brain responses to psychotropic drugs using interleaved pharmacological magnetic resonance imaging (phMRI) and pharmacological magnetic resonance spectroscopy (phMRS). This...
European Journal of Psychotraumatology
April 1, 2026
Maud Rothärmel, Lila Mekaoui, François Kazour et al.
1 citation
Background: Posttraumatic stress disorder (PTSD) is a severe and frequent affection that is highly comorbid to major depressive disorder. Comorbid PTSD and depression increase the risk of treatment-resistant depression (TRD), with a high risk of functional impairment and suicide. Esketamine nasal spray is a recent validated treatment for TRD, but its efficacy on comorbid TRD-PTSD remains...
Cureus
April 1, 2026
Samantha Siu, Peter Hsin, Sarah Simon et al.
Postpartum depression (PPD) is a common condition associated with adverse maternal and infant outcomes. Higher rates have been observed following cesarean delivery, prompting interest in perioperative preventive strategies. Ketamine has demonstrated rapid antidepressant effects and may provide psychiatric benefits beyond analgesia. We conducted a systematic review and meta-analysis of...
Cureus
April 1, 2026
Juan Pablo Berlin Viniegra
Treatment-resistant depression (TRD) remains a major clinical challenge in psychiatric practice and affects a substantial proportion of patients with major depressive disorder (MDD). It is commonly defined as failure to achieve remission after at least two adequately conducted antidepressant trials. TRD is associated with persistent functional impairment, increased morbidity, reduced quality of...
Horizons of Insight: Exploring the Frontiers of Multidisciplinary Science
March 31, 2026
Paulo Artur da Silva Rodrigues, Giovana Dos Santos Couto, Bárbara Corrêa Garcia Simões et al.
Introduction: Treatment-resistant depression (TRD) represents a significant clinical challenge, particularly when associated with suicidal ideation. Intranasal esketamine has emerged as an effective therapeutic option in refractory cases, while monoamine oxidase inhibitors (MAOIs) remain relevant in the management of severe and resistant conditions. Objective: To describe the clinical course of...