Esketamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist, has become a preferred option for perioperative use in infants and young children with low compliance due to its rapid onset and convenient administration. However, concerns regarding its potential neurotoxic effects during development warrant further investigation. This study aimed to elucidate the impact of esketamine on...
BACKGROUND: Disorders of consciousness (DoC) present significant therapeutic challenges with limited effective interventions. The choice of anesthetic agent during procedures such as spinal cord stimulation may influence long-term neurological outcomes, yet comparative evidence is scarce. This prospective, non-randomized, comparative effectiveness trial investigated the neurophysiological and...
Patients with treatment‐resistant depression who received a series of treatments with ketamine or esketamine showed a substantial reduction in emergency department visits related to suicidality over a 6‐month period, a study has found. Study participants had a 56.7% response rate of depression symptoms following the acute phase of treatment.
Regulatory approvals for intranasal esketamine in treatment-resistant depression (TRD) differ with respect to its indication for suicidal ideation. While rapid antidepressant effects are well documented, whether esketamine exerts an anti-suicidal effect independent of mood improvement remains unclear. In this two-center observational study, 261 adults with moderate-to-severe TRD at Sainte-Anne...
Ketamine is increasingly used as a therapeutic option for treatment-resistant depression (TRD) due to its rapid antidepressant properties; however, the mechanisms underlying these effects remain elusive. Preclinical evidence suggests ketamine acts on neural pathways implicated in reward processing, but translational efforts have proven challenging due to a lack of paradigms allowing for...
Esketamine, the S-enantiomer of ketamine, has emerged as a rapid-acting antidepressant with unique mechanisms. This narrative review synthesizes current evidence on its clinical applications, safety, and regulatory status based on peer-reviewed literature published between January 2000 and March 2024, searched in PubMed, Web of Science, and the Cochrane Library. Esketamine exerts its effects...
Growing evidence links inflammation with major depressive disorder (MDD) and treatment resistance. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a simple peripheral marker of systemic inflammation and immune balance and it may capture clinically meaningful heterogeneity in inflammatory burden, potentially contributing to variability in antidepressant response and vulnerability to...
A complex ensemble of neuromodulatory receptors orchestrates the many forms of synaptic plasticity that drive behavioral state changes, but an understanding of how such receptors functionally interact is limited. Here, we find that the antidepressant action of ketamine is dependent on both the receptor tyrosine kinase, tropomyosin-related kinase B (TrkB), and the G protein-coupled receptor,...
Treatment-resistant depression (TRD) remains a significant clinical concern, particularly in patients who do not achieve adequate response with conventional antidepressant therapies. Ketamine and esketamine, which act on glutamatergic pathways, have been introduced into clinical practice as alternative therapeutic approaches within interventional psychiatry. This narrative review outlines key...
Aim This study aims to compare two treatment procedures (standard selective serotonin reuptake inhibitors and rapid-acting therapies/specifically ketamine) for patients suffering from treatment-resistant depression along with evaluating the effectiveness of these approaches in alleviating symptoms and improving patient outcomes. Materials and Methods This study examined 80 patients suffering...
Psychiatria PolskaApril 30, 2026Bronisław Gębik, Katarzyna Bliźniewska-Kowalska, Piotr Gałecki
Od 2000 roku ketamina i jej enancjomery są badane pod kątem swojego działania przeciwdepresyjnego. W niniejszej pracy zostanie krótko podsumowana droga ketaminy od anestetyku do leku przeciwdepresyjnego. W tekście przedstawione zostaną najważniejsze mechanizmy jej działania a także działania jej metabolitów. Praca ta ma na celu opisać rolę konkretnych grup receptorów w aktywacji istotnych...
Depression is driven by dysfunction in discrete neural circuits, but a deeper understanding of the underlying molecular and synaptic mechanisms is needed to guide the development of therapeutics. Here, we decipher the mechanisms of action of the fast-acting antidepressant ketamine to enable the identification of G protein-coupled receptor (GPCR) antidepressant targets. We find that the...
Brain SciencesApril 30, 2026Nathan R Luzum, Marcia H. Mccall, Charlotte Talley Boyd et al.
Background/Objectives: A sub-anesthetic dose of ketamine has shown promise in reducing craving, withdrawal symptoms, and use of drugs such as alcohol, cocaine, and opioids among individuals with substance use disorders. Ketamine’s therapeutic potential for tobacco use is unknown. Here, we investigated a single sub-anesthetic dose among adults with tobacco use disorder who were not interested in...
The treatment of treatment-resistant depression (TRD) remains a clinical challenge. Pharmacologically, several augmentation options exist. The aim of this study was to present a mechanistically informed and clinically oriented decision-making framework for the established strategies of lithium, quetiapine, and esketamine. We conducted a narrative, non-systematic review, performing a targeted...
Depression is a leading global health burden increasingly linked to dysregulation in glutamatergic signaling. Ionotropic glutamate receptors (iGluRs), including NMDA, AMPA, and kainate subtypes, have emerged as pivotal therapeutic targets. However, the rapid expansion of literature has led to a fragmented research landscape, creating an urgent need for a structured overview. This study aims to...
Ketamine produces rapid antidepressant effects in a subset of patients with treatment-resistant depression, yet neuroimaging findings have been difficult to integrate because studies differ in imaging modality, analytic approach, task context, and post-infusion timing. To address this, we conducted a multimodal synthesis of functional magnetic resonance imaging (fMRI) and positron emission...
Treatment-resistant depression (TRD) affects approximately 30% of major depressive disorder(MDD) cases and represents a major unmet clinical need. Ketamine produces rapid antidepressanteffects in TRD, but response is variable and no validated biomarker predicts who will respond.Multiple independent studies have now shown that baseline EEG features -- particularly vigilancestage distribution and...
BMC PsychiatryApril 26, 2026Sergi López-rodríguez, Cinto Segalàs, Eva Real et al.
BACKGROUND: Patients with obsessive–compulsive disorder (OCD) and comorbid major depressive disorder (MDD) represent a severe subgroup with increased treatment resistance, greater functional impairment, and limited therapeutic options. Intranasal esketamine is a rapidly acting treatment for resistant depression, with emerging interest in potential anti-obsessional effects. However, prospective...
Oral esketamine displays therapeutic potential for treatment-resistant depression. However, treatment is complicated by a low and variable bioavailability. Genetic polymorphisms in the cytochrome P450 (CYP) enzymes responsible for esketamine's metabolism may influence bioavailability. In a subsample of patients included in a placebo-controlled trial investigating repeated, low dose oral...
Interleukin-6 (IL-6) has been implicated as a potential predictor of ketamine response in treatment-resistant depression (TRD). Esketamine, the S-enantiomer of ketamine, produces rapid antidepressant effects and offers improved safety and intranasal administration. To examine whether baseline IL-6 predicts treatment response to esketamine in individuals with TRD. Fourteen adults with TRD...