Treatment-Resistant Depression (TRD) remains a major challenge in the management of Major Depressive Disorder (MDD). Esketamine, the S-enantiomer of ketamine and a glutamatergic modulator, was approved by the FDA and EMA for TRD in 2019. Beyond its rapid antidepressant effects, esketamine may enhance neuroplasticity, facilitating the reconnection with emotional and cognitive processes,...
Depression is a debilitating psychiatric disorder. Electroconvulsive therapy (ECT) and ketamine are effective treatments for severe depression, but target populations may differ. Systematic reviews on the few available trials show higher remission rates with ECT than with ketamine. Nonetheless, ketamine’s rapid onset of action is comparable to ECT but with less cognitive adverse effects. This...
Ketamine2025Jose Eduardo Guimaraes Pereira, Carlos Darcy Alves Bersot, Thiago Ramos Grigio et al.1 citation
Neuropathic pain (NP) is a frequently undertreated component of chronic pain, posing challenges due to its complexity. This has led to interest in N-methyl-D-aspartate receptor (NMDAR) antagonists like ketamine. NP is linked to maladaptive processes, such as NMDAR-related windup and sensitization. While results from ketamine trials on chronic NP have been inconsistent, perioperative use has...
Although both intranasal esketamine and intravenous ketamine have proven efficacy and tolerability in treatment-resistant depression (TRD), patient access to these treatments is often limited due to cost, availability, and/or monitoring requirements. This article is intended to provide a synthesis of the current literature with regard to the pharmacologic use of ketamine in TRD and describe its...
Ketamine produces fast-acting antidepressant effects in treatment-resistant depression (TRD). Prior studies have shown altered functional dynamics between brain networks in major depression. We thus sought to determine whether functional brain network dynamics are modulated by ketamine therapy in TRD. Participants with TRD (n = 58, mean age = 40.7 years, female = 48.3%) completed resting-state...
Nasal esketamine has demonstrated efficacy in the management of treatment-resistant depression and psychiatric emergency due to major depression. This study investigates acceptance and awareness of esketamine as a depression treatment option, focusing on factors that influence patients' acceptance, including adherence to current medication regimens, regardless of prior esketamine exposure. This...
Ketamine and esketamine have demonstrated rapid, short-term antidepressant effects in major depressive disorder (MDD), but their relative safety remains unclear. This review aims to update the evidence on the safety of two agents for MDD and indirectly compare their safety and tolerability. We systematically searched PubMed, PsycINFO, Embase, and Cochrane databases up to 1 May 2025. Eligible...
Ketamine's antidepressant effects have been linked to its modulation of glutamatergic neurotransmission and synaptic plasticity. However, the precise roles of both glutamate (Glu) levels and brain-derived neurotrophic factor (BDNF) in this process remain incompletely understood. This study examined the relationship between ketamine-induced changes in Glu levels and peripheral BDNF levels using...
Depression affects approximately 5.7% of adults worldwide, and around one-third of these individuals develop treatment-resistant depression (TRD). Intravenous (IV) ketamine and esketamine (administered IV or intranasally (IN)) are novel treatment options for TRD; however, only IN esketamine currently holds FDA approval. Compare the acute effectiveness of IV ketamine with esketamine (IV or IN)...
Intravenous ketamine is effective in treatment-resistant bipolar depression (TRBD) with dosing typically based on actual body weight (ABW). This study examined whether alternative normalization formulas are associated with treatment response. A retrospective exploratory analysis of a naturalistic registry for short-term ketamine use. A total of 22 TRBD inpatients received short-term intravenous...