Treatment-resistant depression (TRD) affected nearly 20–30% of individuals diagnosed with major depressive disorder and remained a significant therapeutic challenge. The lack of response to traditional antidepressant therapies placed a substantial emotional, functional, and economic burden on patients and healthcare systems. In recent years, ketamine and electroconvulsive therapy (ECT) emerged...
Research SquareSeptember 26, 2025Soria López, Cinto Segalàs, Eva Real et al.
preprint
Abstract Background: Intranasal esketamine has gained attention as a rapidly acting intervention for treatment-resistant depression, and there is growing interest in its potential anti-obsessional effects. To our knowledge, no published case series has focused on intranasal esketamine in patients with both treatment-resistant obsessive–compulsive disorder (TR‑OCD) and comorbid major depression...
Ketamine has anti depressive characters and approved by (FDA) for the induction and maintenance of anesthesia, Ketamine has been incorporated into the management of psychiatric disorders, such as Major Depressive Disorder (MDD) especially with suicidal ideation or attempting, and of label in management of Bipolar Disorder, Post-Traumatic Stress Disorder (PTSD), Obsessive-Compulsive Disorder...
This case report describes the management of a 38-year-old female with recurrent depressive disorder, who presented with severe depressive symptoms and active suicidal ideations. She reported persistent low mood, loss of interest in pleasurable activities, fatigue, and disturbed sleep for nearly three weeks, with recurrent thoughts of ending her life in the preceding week. Despite being on...
Abstract Introduction Treatment-resistant depression (TRD) affects up to one-third of patients with major depressive disorder, leading to poor outcomes and increased suicide risk. Esketamine nasal spray, a novel glutamatergic modulator, has emerged as an adjunctive option with rapid onset of action. However, the efficacy and safety of esketamine across randomized controlled trials (RCTs) remain...
Maintenance intravenous racemic ketamine therapy demonstrated significant, persistent, and broad efficacy for treatment-resistant depression as demonstrated by reductions in Montgomery-Åsberg Depression Rating Scale and Patient-Health Questionnaire-9 total scores and equivocal changes in every item on both rating scales. The magnitude of change in individual items was similar to that of...
Objective: Both intravenous (IV) racemic ketamine and intranasal (IN) esketamine have emerged as rapid-acting antidepressants for treatment-resistant depression (TRD) and are increasingly used in clinical settings. Relatively few studies, however, have compared these interventions in larger, naturalistic cohorts. This study was conducted to assess the comparative efficacy and rapidity of...
This is the first systematic review to assess the effectiveness of ketamine/esketamine in this cohort. Our findings suggest that ketamine/esketamine may be useful in improving symptoms of depression, in those with comorbid borderline personality disorder. Limited study data are available; however, given case reports of suicidal ideation and self-harm following treatment cessation, as well as...
Background: Treatment-resistant depression (TRD) has a poor response to clinical treatment. Patients with TRD do not respond adequately to standard antidepressants. Even after receiving a full dose and sufficient duration of combined antidepressant therapy, significant improvement is still difficult to achieve. At present, electroconvulsive therapy (ECT) remains a clinically effective method...
Conclusions: Ketamine and esketamine reduced long-term ED visits for suicidality in individuals with TRD. Further longer-term follow-up research is encouraged to ascertain if these benefits on suicidality reduction are mood state dependent or reflect an independent mechanism.