Treatment-resistant depression (TRD) poses a major challenge in research and clinical practice. Various guidelines recommend different pharmacological approaches. While lithium and second-generation antipsychotics have traditionally been the drugs of choice in cases of medication resistance, recent years have seen increasing evidence for the efficacy of esketamine as a fast-acting agent against...
Treatment-resistant depression (TRD) imposes major individual and societal burden, with few therapeutic options. Intranasal esketamine is approved but limited by cost and accessibility, prompting interest in alternatives. To assess non-inferiority of racemic ketamine versus esketamine in a real-world setting. We performed a single-centre, retrospective observational study emulating a randomized...
BACKGROUND: In our previous study, we showed that a low dose of esketamine could alleviate propofol-induced injection pain during general anesthesia induction. However, the dose-response relationship of esketamine remains unclear. This study aims to evaluate the dose-dependent efficacy of esketamine in preventing propofol-induced injection pain. METHODS: In this double-blind, randomized...
While perioperative esketamine use has grown increasingly prevalent, evidence supporting its efficacy and safety in elderly patients undergoing laparoscopic prostate cancer surgery remains limited. This retrospective study evaluated intravenous esketamine's performance in this population by analyzing 186 elderly patients treated between 2021 and 2024, divided into a control group (n = 91;...
BackgroundDelirium is a common and serious complication in critically ill and surgical patients, associated with increased morbidity, prolonged hospitalization, and long-term cognitive impairment. Ketamine and esketamine have been proposed as potential protective agents due to their anti-inflammatory, analgesic, and NMDA receptor-blocking properties.MethodsWe conducted a systematic review and...
BMC PsychiatryJanuary 4, 2026Carl D. Marci, Kruti Joshi, Stevan Geoffrey Severtson et al.2 citations
Abstract Background Treatment-resistant depression (TRD) is often characterized by inadequate response to ≥ 2 oral antidepressant treatments of adequate dose and duration during a major depressive episode (MDE). Esketamine nasal spray (ESK) was approved by the US Food and Drug Administration in 2019 for TRD in conjunction with an oral antidepressant under a Risk Evaluation and Mitigation...
Postoperative neurocognitive disorder (PND) is a clinically important complication in older surgical patients. Microglial inflammatory activation is frequently accompanied by altered cellular metabolism, but whether esketamine-associated neuroprotection is accompanied by bioenergetic changes in hippocampal CD11b-enriched cell fractions remains incompletely understood. A tibial fracture model...
BACKGROUND: Treatment-resistant depression (TRD) affects approximately one-third of patients with major depressive disorder and represents a critical clinical challenge. Esketamine (S-ketamine, Spravato), approved by FDA and EMA since 2019, and psychedelic-assisted therapies (psilocybin, MDMA) share a pharmacological feature unique among approved psychiatric treatments: they induce altered...
Beyond its antidepressant effects, esketamine (ESK) has the potential to enhance neuroplasticity, facilitating the reconnection with emotional and cognitive processes, improving social cognition, and promoting resilience. However, not much is known about its role in Alzheimer's disease (AD). This study aims to explore the potential mechanism of ESK in AD treatment. The potential targets of ESK...
Surgical stress can lead to postoperative anxiety and depression, especially in adolescents. These complications reduce quality of life and increase medical burdens, but perioperative psychological interventions for adolescents are limited, and related mechanisms remain unclear. Esketamine (S-ketamine), an N-methyl-D-aspartate receptor (NMDAR) antagonist, has analgesic, sedative,...