The Journal of Clinical Psychiatry
May 4, 2026
Samuel T. Wilkinson, Brandon Kitay, Matthew Macaluso et al.
Background: Suicide is a public health crisis in the US, with limited evidence demonstrating efficacy of treatments for high-risk patients due in part to their exclusion from most clinical trials. This clinical trial evaluates the feasibility and efficacy of adjunctive cognitive behavioral therapy (CBT) with esketamine in patients with major depression and suicidal ideation (MDSI). Methods:...
The International Journal of Neuropsychopharmacology
May 3, 2026
Mostafa El Mansari, Naomichi Okamoto, Pierre Blier
Abstract Background In preclinical studies, an increase in α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) to N-methyl-D-aspartate (NMDA) receptor throughput is the predominant hypothesis posited to explain the rapid antidepressant effect of ketamine and S-ketamine. Several lines of evidence show that this AMPA increase takes place in the medial prefrontal cortex (mPFC), which...
Journal of Biochemical and Molecular Toxicology
May 1, 2026
Jingyi Wang, Shuo Huang, Tingting Lin et al.
Esketamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist, has become a preferred option for perioperative use in infants and young children with low compliance due to its rapid onset and convenient administration. However, concerns regarding its potential neurotoxic effects during development warrant further investigation. This study aimed to elucidate the impact of esketamine on...
CNS Neuroscience & Therapeutics
May 1, 2026
Xuewei Qin, Xuanling Chen, Lan Yao et al.
BACKGROUND: Disorders of consciousness (DoC) present significant therapeutic challenges with limited effective interventions. The choice of anesthetic agent during procedures such as spinal cord stimulation may influence long-term neurological outcomes, yet comparative evidence is scarce. This prospective, non-randomized, comparative effectiveness trial investigated the neurophysiological and...
Journal of Affective Disorders
May 1, 2026
Michel Danon, Gabriela Ostronoff, Anne-Cécile Petit et al.
Regulatory approvals for intranasal esketamine in treatment-resistant depression (TRD) differ with respect to its indication for suicidal ideation. While rapid antidepressant effects are well documented, whether esketamine exerts an anti-suicidal effect independent of mood improvement remains unclear. In this two-center observational study, 261 adults with moderate-to-severe TRD at Sainte-Anne...
Medicine
May 1, 2026
Hai-Lin Hu, Qi-Zhou Huang, Ping-Xia Xie
Esketamine, the S-enantiomer of ketamine, has emerged as a rapid-acting antidepressant with unique mechanisms. This narrative review synthesizes current evidence on its clinical applications, safety, and regulatory status based on peer-reviewed literature published between January 2000 and March 2024, searched in PubMed, Web of Science, and the Cochrane Library. Esketamine exerts its effects...
Journal of Clinical Psychopharmacology
May 1, 2026
Matteo Carminati, Mattia Tondello, Chiara Morana et al.
Growing evidence links inflammation with major depressive disorder (MDD) and treatment resistance. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a simple peripheral marker of systemic inflammation and immune balance and it may capture clinically meaningful heterogeneity in inflammatory burden, potentially contributing to variability in antidepressant response and vulnerability to...
Cureus
May 1, 2026
Amalesh S Honnekeri
Treatment-resistant depression (TRD) remains a significant clinical concern, particularly in patients who do not achieve adequate response with conventional antidepressant therapies. Ketamine and esketamine, which act on glutamatergic pathways, have been introduced into clinical practice as alternative therapeutic approaches within interventional psychiatry. This narrative review outlines key...
International Journal of Psychiatry in Clinical Practice
April 29, 2026
David Eckert, Siegfried Kasper
The treatment of treatment-resistant depression (TRD) remains a clinical challenge. Pharmacologically, several augmentation options exist. The aim of this study was to present a mechanistically informed and clinically oriented decision-making framework for the established strategies of lithium, quetiapine, and esketamine. We conducted a narrative, non-systematic review, performing a targeted...
BMC Psychiatry
April 26, 2026
Sergi López-rodríguez, Cinto Segalàs, Eva Real et al.
BACKGROUND: Patients with obsessive–compulsive disorder (OCD) and comorbid major depressive disorder (MDD) represent a severe subgroup with increased treatment resistance, greater functional impairment, and limited therapeutic options. Intranasal esketamine is a rapidly acting treatment for resistant depression, with emerging interest in potential anti-obsessional effects. However, prospective...