Oral esketamine is a potentially effective and well-tolerated treatment for treatment-resistant depression (TRD). However, around 50% of TRD individuals treated with oral esketamine do not achieve response, and this variation in response may be accounted for by interindividual differences between patients. Efforts to develop effective and personalized depression treatment strategies are...
Background/Aim: Ketamine is frequently administered for analgesia and sedation during burn dressing changes, but its potential psychological impact remains a concern. This study assessed whether ketamine exposure during early burn care is associated with subsequent depression, acute stress reaction (ASR), or post-traumatic stress disorder (PTSD) in patients with major burns. Methods: A...
ObjectivesTo systematically review the effectiveness, safety, and care models of telehealth-supported ketamine for depression and/or anxiety in adults and consider implications for Australasian clinical practice.MethodsFollowing PRISMA 2020, we searched for randomised or observational studies of adults receiving at-home telehealth-supported ketamine for depression and/or anxiety, to August...
Psychedelic therapies are moving from the margins of medicine into clinical practice, bringing unresolved ethical questions to the forefront. Among them, ketamine-assisted psychotherapy (KAP) has gained the widest medical acceptance, particularly for treatment-resistant depression (TRD). In August 2025, this development reached a new stage as Norway became the first country to approve...
Esketamine has demonstrated efficacy in treatment-resistant depression (TRD), but medium-term real-world functional outcomes remain understudied. This study described 6-month depressive symptoms and functional trajectories during routine esketamine treatment, focusing on functional outcomes and remission correlates. In this prospective multicenter study, 60 patients with TRD initiating...
Ketamine-assisted psychotherapy (KAP) is an emerging treatment approach that may enhance ketamine's antidepressant effects through neuroplastic synergism or transformative psychological experience. Despite growing clinical use, real-world KAP practices remain understudied. This cross-sectional survey examined the practices of fifty licensed KAP providers treating depression, recruited from a...
Attention deficit and hyperactivity disorder (ADHD) is a prevalent neuropsychiatric disorder (Drechsler et al., 2020). Recently, psychedelics have become of interest regarding developing treatment options for ADHD. The aim of this systematic review is to find all studies from the APA PsychInfo and MEDLINE databases, where psychedelics have been used for ADHD and assess whether further clinical...
High-dose MDMA tablets and variable-purity cocaine and ketamine samples are commonly encountered by drug checking services and police forces in the United Kingdom and Europe. At the time of writing, there are few simpleto-operate field-portable technologies that provide semi-quantitative information on MDMA tablet dosage or cocaine and ketamine purity at the point of sampling. We previously...
Introduction: Esketamine nasal spray (EN) has been approved in Germany since 2021 for the treatment of treatment-resistant depression (TRD). Historically, the development of EN resulted from the positive results of randomized clinical trials on the off-label use of subnarcotic ketamine infusions (SKI) for TRD. How effective, tolerable, and safe is off-label SKI compared to EN? Methods: Narrativ...
Little is known about esketamine's effectiveness for patients with major depressive disorder (MDD) comorbid substance use disorders (SUD). We conducted a retrospective cohort study using the TriNetX US Collaborative Network, including adults aged ≥18 years with MDD. Three propensity-score-matched (1:1) cohorts were defined based on treatment: esketamine, antidepressant-only, and repetitive...
Suicide, the individual desire to take one's own life, at whose core lies the unbearable psychological pain Shneidman called psychache, is a uniquely human experience. Unlike depression, suicidality has no preclinical analog. Suicidality and chronic depression, long treated as a single clinical entity, are increasingly recognized as partly separable in neurobiology and treatment response....
Repetitive transcranial magnetic stimulation (rTMS) and intranasal esketamine are FDA-approved for treatment-resistant depression (TRD), yet comparative real-world data on response trajectories and predictors of outcomes remain limited. A retrospective analysis was performed using electronic medical records from UC San Diego Health. Adults with TRD treated with rTMS (n = 279) or intranasal...
Ketamine, a non-competitive N-Methyl-D-Aspartate receptor antagonist, was approved for use with Treatment-Resistant Depression (TRD) and is currently in clinical trials for treating substance use disorder (SUD), and Post Traumatic Stress Disorder. However, ketamine is an addictive drug, and thus we need to better understand ketamine's mechanism of action in addiction to reliably assess the...
To compare the efficacy and safety of electroconvulsive therapy (ECT) and ketamine infusion (KET-IFU) in routine care for patients with bipolar I or II depression (BPD). Electronic medical records of patients who received ECT and/or KET-IFU were used to identify patients with BPD who received both ECT and KET-IFU treatments. The change in the 16-item Quick Inventory of Depressive Symptomatology...
Harm Reduction JournalJune 4, 2026Ignacio Bórquez, Bruno Pantaleão, Gabriela Brogim et al.
The illicit drug landscape in South America is going through a major shift. The appearance of Tusi (or "pink cocaine"), a mixture often containing ketamine and MDMA, along with the growing presence of synthetic opioids like fentanyl and nitazenes, signals a new chapter in the region's drug use, which has been traditionally dominated by alcohol, cannabis, and cocaine. Drawing on data on...
Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, was first approved by the US FDA as KETALAR® for induction and maintenance of general anesthesia. Ketamine has been used off-label for depression treatment, while its S-enantiomer, esketamine (SPRAVATO®), is approved for treatment-resistant depression and major depressive disorder with acute suicidal ideation or behavior. High doses...
Ketamine-assisted psychotherapy (KAP) is moving from the periphery toward the mainstream of mental healthcare. Research on the use of KAP in the context of couple therapy, however, remains limited. This phenomenological analysis sought data from psychotherapists ( n = 9), representing four different modalities of couple therapy, who are incorporating ketamine into their work with dyads....
bioRxivJune 3, 2026Yanxia Liang, Lingjun Wang, Yajie Li et al.
preprint
Ketamine produces rapid antidepressant effects but is constrained by psychotomimetic properties and abuse potential. The ketamine metabolite (2R,6R)-hydroxynorketamine (HNK) shows antidepressant-like efficacy without N-methyl-D-aspartate receptor (NMDAR) blockade, yet its upstream targets remain unclear. Here we show that HNK potentiates hippocampal excitatory transmission and reverses...
bioRxivJune 3, 2026Shuo Yang, Ling-Jun Wang, Yunxiang Sun et al.
preprint
Abstract A deeper understanding of the targets and mechanisms of fast-acting antidepressants, exemplified by ketamine, remains indispensable for better therapeutic strategies and understanding depression. Beyond the canonical neuron-centric NMDAR inhibition hypothesis, brain opioid system and glia-mediated processes are increasingly implicated in ketamine’s antidepressant efficacy, yet their...
CJEMJune 3, 2026Yury Onikashvili, Heather Burt, Garth Meckler et al.
ObjectivesEmergency department (ED) visits by adolescents with suicidal ideation have increased, with no rapid-acting treatments identified for ED use. This pilot study explored the feasibility of a randomized controlled trial of ketamine in the ED for adolescents with suicidal ideation.MethodsThree-arm, triple-blinded randomized controlled trial comparing intravenous ketamine (0.5 mg/kg),...