Research Square
June 2, 2026
Davis Carter, Ian Reardon, Jack Swain et al.
preprint
Abstract Background Prolonged grief disorder (PGD) is a clinically distinguishable bereavement-related condition characterized by persistent yearning, identity disruption, and impaired functioning, formalized in DSM-5-TR and ICD-11 (6L72) and empirically distinguishable from but frequently co-occurring with major depressive disorder. Approximately 7 to 10 percent of bereaved adults meet...
European Psychiatry
June 1, 2026
P.-M. Llorca, Ludovic Samalin, Emilie Olié et al.
Introduction: Esketamine nasal spray (ESK) was approved in 2019 in Europe for adults with Treatment-Resistant Depression (TRD), defined as inadequate response to at least two different antidepressants during the current moderate to severe depressive episode Objectives: To assess patient-reported outcomes related to symptomatology, quality of life, and occupational impairment over 12 months...
European Psychiatry
June 1, 2026
Miriam Olivola, V. Martiadis, Kevin la Monica et al.
Introduction The role of dissociation in mediating antidepressant response to intranasal esketamine remains debated. While dissociative experiences are often observed during treatment, their predictive value for clinical outcomes is uncertain. Objectives We aimed to assess whether (i) baseline dissociative traits (DES-II) and (ii) early changes in dissociation (ΔDES T0→T2) predict short-term...
European Psychiatry
June 1, 2026
V. Casati, Kevin la Monica, Mauro Angeletti et al.
Introduction Intranasal esketamine has emerged as an innovative treatment for TRD due to its rapid antidepressant effects. However, the clinical response is heterogeneous, and growing evidence suggests that comorbid personality disorders (PDs) may significantly shape treatment outcomes. Although PDs are frequently diagnosed in TRD patients, little is known about their differential influence on...
European Psychiatry
June 1, 2026
Giada Versaci, Miriam Olivola, Kevin la Monica et al.
Introduction Esketamine-induced dissociation is a transient, pharmacologically mediated alteration in consciousness, often distinct from pathological dissociation. While not required for clinical improvement, these states may engage neural circuits implicated in therapeutic change. Objectives This study explores patients’ lived experiences of dissociation as potentially meaningful transitional...
European Psychiatry
June 1, 2026
P. Argitis, M. Demetriou, T. Koukouras et al.
Introduction Intravenous (IV) ketamine has demonstrated rapid antidepressant and anti-suicidal effects in treatment-resistant depression (TRD), yet interindividual variability in response remains significant. One unexplored factor is the impact of concomitant antidepressant medication during ketamine treatment. Desvenlafaxine, a serotonin-norepinephrine reuptake inhibitor (SNRI), may enhance...
European Psychiatry
June 1, 2026
P. Argitis, M. Demetriou, V. Anagnostopoulou et al.
Introduction Acute suicidal ideation after a suicide attempt is a psychiatric emergency requiring immediate treatment. IV ketamine (0.5 mg/kg), with rapid onset, may offer such benefit. This study examines its efficacy and safety as a first-line intervention for swiftly resolving suicidal ideation in patients post-attempt, including in outpatient and consultation-liaison psychiatry settings....
BJPsych Open
June 1, 2026
Emeka Onochie, Saminathan Anand, Collins Esiwe et al.
Aims: Ketamine misuse is an emerging public health concern, with increasing reports of severe physical and psychological complications. Chronic use is associated with hepatobiliary and urinary tract injury, often linked to ketamine’s metabolic pathways and toxicological effects (1-3). This report describes the complications and treatment outcomes of a young adult with severe ketamine dependence...
European Psychiatry
June 1, 2026
Cristina Serritella, L. Iorio, F. Ferraiuolo et al.
Introduction Intranasal esketamine provides a rapid therapeutic option for treatment-resistant depression but can induce transient blood pressure increases. The influence of psychopathological traits on these cardiovascular responses remains largely unexplored. Objectives The present study aims to investigate the acute effects of intranasal esketamine on systolic and diastolic blood pressure as...
Journal of Psychopharmacology
June 2026
Vasilios G Masdrakis, Zoe Tebbs, Vasilios Natsis et al.
Ketamine and esketamine ("es/ketamine") treatment protocols have been investigated in patients' samples with treatment-refractory anxiety disorders. We systematically reviewed publications in which es/ketamine was used to treat anxiety symptoms in the context of either Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) anxiety disorders or treatment-resistant...
BJPsych Open
June 1, 2026
Sarah Shackleton, Onuswale Oni, Stephen J. Kaar
Aims: Recreational ketamine use and treatment-seeking for associated complications is increasing in England. Complications of ketamine dependence can be debilitating, leading to continued dependence and surgical intervention. However, treatment remains under-researched, with lacking understanding of those seeking treatment or requiring specialist inpatient detoxification. This study aims to...
European Psychiatry
June 1, 2026
L. Mana, R. Lisbino, P. Pezzella et al.
Introduction Ketamine and esketamine exert rapid antidepressant and dissociative effects, and the growing clinical use of intranasal esketamine for depression opens the possibility of large-scale electroencephalography (EEG) studies to explore their mechanisms through a non-invasive approach. However, understanding the neurophysiological basis of these effects requires a clear synthesis of...
European Psychiatry
June 1, 2026
V. Martiadis, Fabiola Raffone, Serena Testa et al.
Introduction Treatment-resistant depression (TRD) is a severe condition associated with high suicide risk and limited response to conventional antidepressants. Intranasal esketamine has shown rapid efficacy in reducing depressive symptoms and suicidal ideation. Objectives This observational study assessed the real-world effectiveness of esketamine in reducing suicidal ideation, self-harm...
European Psychiatry
June 1, 2026
O. Płaza, Robert Madejek, M. M. Dutsch-Wicherek et al.
Introduction Treatment-resistant depression (TRD), which affects about 30% of patients with major depressive disorder, emerges when patients do not respond adequately to at least two antidepressant trials of proper dose and duration. The EMA approved esketamine nasal spray, the first registered psychedelic medication, in 2019 for TRD treatment. In July 2023, Poland launched B.147, the country’s...
European Psychiatry
June 1, 2026
Nawfel Ayad, Samer Makhoul
Introduction Treatment-resistant depression (TRD) poses a significant clinical challenge, with limited evidence guiding long-term pharmacological strategies. Esketamine, a glutamatergic modulator, has demonstrated short-term efficacy in TRD, but data on its extended use in real-world settings remains scarce Objectives This study aimed to evaluate the long-term effectiveness and tolerability of...
European Psychiatry
June 1, 2026
T. Sagues, A. Barnes, C. Fernández et al.
Introduction Intranasal esketamine has emerged as an innovative option for the management of treatment-resistant depression (TRD), offering a novel mechanism of action and rapid antidepressant effects. However, evidence regarding the clinical trajectory after treatment discontinuation remains limited, raising questions about the durability of its therapeutic benefits and the optimal maintenance...
European Psychiatry
June 1, 2026
O. Vasiliu, D. G. Vasiliu
Introduction Hopes related to esketamine have been raised by its approval for treatment-resistant major depression (TRD) in the sense that this antidepressant, with a novel mechanism of action, will be useful for patients with bipolar depression (BD), too. The need to find more evidence-based pharmacological approaches to both TRD and BD is acute due to the high rates of partial response or...
European Psychiatry
June 1, 2026
Nawfel Ayad, Samer Makhoul, F. Alkhaja
Introduction Treatment-resistant depression remains a major clinical challenge, with many patients experiencing relapse despite advances in medication and psychotherapy. Esketamine offers rapid relief from depressive symptoms, while psychotherapy helps patients build lasting skills to manage their condition. Despite their individual effectiveness, little is known about how these treatments work...
European Psychiatry
June 1, 2026
E. D. Cindik-Herbrueggen, A. S. Kucukali
Introduction Adult attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with mood and anxiety disorders (Sandstrom et al. Acta Psychiatr Scand 2021;143 380–391), and when major depressive disorder (MDD) is present, it often follows a treatment-resistant course (Thapar et al. J Child Psychol Psychiatry 2023;64 4–15). Intranasal esketamine, a non-competitive NMDA-receptor...
European Psychiatry
June 1, 2026
Jesús García-Jiménez, S. Posik, B. Herrejón et al.
Introduction Treatment-resistant depression (TRD) is highly burdensome. Intranasal esketamine is effective, yet hospital-centric delivery adds travel and continuity barriers that may hinder adherence and outcomes. We hypothesize that community outpatient, patient-proximal delivery —often with the patient’s usual psychiatrist—improves effectiveness, engagement and acceptability, consistent with...