Background: Major depressive disorder (MDD) is increasingly framed as a failure of neuroplasticity. Excessive synaptic pruning in adolescence can leave circuits fragile; later stress then unmasks the weakness, whereas ketamine and related compounds can quickly rebuild critical synapses. Clinical data show that a single treatment often gives short relief, while repeated courses reduce relapse....
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...
Early life stress is a well-established risk factor for psychiatric disorders in adulthood; however, the underlying molecular mechanisms remain unclear. This study investigated the effects of chronic unpredictable mild stress (CUMS) starting in adolescence on anxiety- and depression-like behaviors, as well as on hippocampal miR- 34a, SIRT1, BDNF, and NLRP3 levels in rats treated with ketamine...
Perioperative anxiety and depression are common following major orthopaedic surgery and may adversely affect postoperative recovery. Ketamine and esketamine have rapid psychotropic effects; however, their effectiveness in reducing postoperative mood symptoms in orthopaedic patients remains uncertain. We systematically reviewed randomized evidence on the effects of these agents on postoperative...
Ketamine and esketamine maintenance treatment show promise in maintaining initial antidepressant effects, yet further research is needed to optimize long-term outcomes. This observational study aimed to assess long-term depression symptom severity, safety, and tolerability in a cohort of patients receiving at-home oral esketamine maintenance treatment. Between June 2017 and March 2024, 221...
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...
A BSTRACT Major depressive disorder is commonly associated with suicidal ideation, while conventional antidepressants have a delayed onset of action. Ketamine has emerged as a rapid-acting antidepressant with potential anti-suicidal effects. This retrospective case series evaluated the effectiveness and tolerability of intravenous ketamine in patients with major depressive disorder and active...
Treatment-resistant depression (TRD) affects about one-third of people with major depression and leads to higher suicide rates, impaired functioning, and increased healthcare use. Originally defined as nonresponse to tricyclic antidepressants, TRD now encompasses inadequate response to multiple antidepressant classes, psychotherapy, and neuromodulation. Inconsistent criteria-varying by agency,...
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,...
Esketamine is increasingly being applied for preventing postpartum depression (PPD). However, clinical protocols for this application are inconsistent, particularly concerning the route of administration. The aim was to determine whether esketamine bolus administration differed from continuous infusion in terms of preventing PPD. A total of 503 subjects without prenatal depression undergoing...