Treatment-resistant depression (TRD) remains a major clinical challenge, and long-term real-world data on intranasal esketamine are limited. To describe long-term dosing patterns and clinical outcomes associated with intranasal esketamine in routine clinical practice. Single-center observational cohort study with descriptive analyses. We analyzed 45 patients with TRD treated with intranasal...
Treatment-resistant depression (TRD) is often accompanied by persistent suicidal ideation and poor response to conventional antidepressants. Intranasal esketamine, a non-selective NMDA receptor antagonist, provides rapid antidepressant and anti-suicidal effects; transient dissociation is common, whereas ataxia-like "drunken gait" is rarely described. A 19-year-old woman with recurrent...
Esketamine, the S-enantiomer of ketamine, is a rapid-acting antidepressant approved for treatment-resistant depression (TRD) when used in combination with an oral antidepressant. Identifying reliable clinical or genetic predictors of treatment response remains a critical unmet need. This study aimed to evaluate the impact of selected clinical and genetic variables on esketamine response in a...
Treatment-resistant juvenile depression is a globally prevalent issue, with a need for better pharmacotherapy. Typically, Selective Serotonin Reuptake Inhibitors are front line, but recently there is interest in examining using ketamine or esketamine adjunct in adolescents. In this study, a novel method is used to explore the adverse effects of sub-anesthetic doses of ketamine in a female...
This study systematically evaluated the safety profile of esketamine for treatment-resistant depression through a meta-analysis, focusing on dose-dependent adverse events and associated risk factors to inform precision dosing. PubMed, Embase, the Cochrane Library, the Mainland China Biomedical Literature Database (CBM), the China National Knowledge Infrastructure (CNKI) and Wanfang databases...
Treatment-resistant depression (TRD) and bipolar depression (TRBD) are severe, heterogeneous mood disorders associated with substantial functional impairment, elevated suicide risk and persistent unmet treatment needs. While pharmacological and psychological interventions continue to advance, many patients experience delayed, partial or unsustained benefit, underscoring the need for therapies...
Ketamine has emerged as a promising rapid-acting antidepressant for treatment-resistant depression (TRD), yet its mechanisms of action and reliable biomarkers of treatment response remain poorly understood. Recent evidence suggests that the aperiodic exponent (1/f slope) of electroencephalography (EEG) power spectra reflects cortical excitation-inhibition balance (EIB), offering a potential...
Major depressive disorder (MDD), including treatment-resistant depression (TRD), is a highly prevalent psychiatric disorder. MDD is associated with severe suffering, burden and large economical costs. Although various conventional antidepressant treatments are available, a large portion of depressed people does not or not adequately respond to the first-line treatments (mostly SSRIs and SNRIs)...
Healthcare providers' (HCPs) perspectives on psychedelic-assisted therapy (PAT) are critical to clinical integration but remain underexplored in Canadian palliative and oncology contexts. This study examines HCP attitudes toward ketamine, psilocybin, and MDMA, and the systemic and ethical factors influencing implementation. An exploratory qualitative study using semi-structured interviews was...
Figshare2026Daniel Pustay, Vishal Patel, Krista Ulisse et al.
preprint
Treatment-resistant depression (TRD) remains a complex challenge, often requiring interventions beyond standard medications. This review explores factors that may predict positive response to electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS) and ketamine-based treatments to help guide clinical decision-making. A systematic review was conducted following PRISMA...
The reported mixed findings suggest that the opioid system may exert a partial mediating effect of ketamine in TRD. However, given the inconsistent attenuation of ketamine's antidepressant effects by opioid receptor antagonists, the opioid system likely functions as a context-dependent modulator rather than a primary mediator, particularly at standard antidepressant doses.
This preregistration documents an update and extension of a meta-analysis of ketamine and esketamine for adults with treatment-resistant major depressive disorder (TRD). The project is nested within an existing network meta-analysis for TRD (NMA-TRD) project, which has already been fully specified and registered: • Muit et al., BMJ Open 2022 – protocol for a systematic review and network...
Brain and Behavior2026Filipa Alves Da Silva, Rita Avelar, Bernardo Peixoto et al.
Depression affects around 280 million people worldwide, and about 30% of patients have treatment-resistant depression. Ketamine has significant scientific evidence supporting its use as an antidepressant, making it a promising approach for treatment-resistant cases. Combining ketamine with psychotherapy may enhance therapeutic response and support longer-lasting cognitive and behavioral change....
Glenohumeral dislocation is the most common type of shoulder dislocation and a leading cause of shoulder instability. Adequate muscle relaxation and pain control are essential for successful reduction. This study compared the effectiveness and safety of ketamine-midazolam (KM) versus ketamine-propofol (KP) for procedural sedation in anterior shoulder dislocations in the emergency department...
PLoS One2026Yijun Wang, Xiaolu Lin, Xiang Zou et al.
Postoperative pain is the most notable issue after cesarean section (CS). The contributing factors include hyperalgesia, anxiety, depression, sleep disorders, and inflammation. In this study, we explored the effects of esketamine on pain, hyperalgesia, depression, anxiety, sleep disorders, and inflammation after CS. This randomized, blinded, controlled trial enrolled single-term pregnant women...
Chronic ketamine abuse is a well-recognized cause of lower urinary tract injury. Hepatobiliary manifestations are less frequently reported. A case is presented of concomitant ketamine-induced uropathy and cholangiopathy in a young adult. This underscores the importance of considering ketamine toxicity as a multisystem disorder. Teaching point: Beyond the well-recognized urinary tract...
The efficacy of standard 5-fluorouracil (5-FU) chemotherapy for colorectal cancer is limited by drug resistance and adverse effects, prompting research into esketamine, a potent ketamine variant with analgesic, antidepressant, and recently discovered anti-tumor properties, to determine if it can enhance 5-FU's chemosensitivity. This study investigates whether esketamine synergizes with 5-FU to...
Anhedonia is a key symptom of bipolar depression and a target of ketamine's rapid antidepressant effects. However, many patients with treatment-resistant bipolar depression (TRBD) do not respond. This study aimed to identify clinical and sociodemographic characteristics that are associated with nonresponse of anhedonia following short-term ketamine treatment in TRBD. A retrospective analysis...
ChemMedChem2026Juulia Järvinen, Santosh Kumar Adla, Janne Tampio et al.
Ketamine, a rapid-acting N-methyl-D-aspartate (NMDA) receptor antagonist, has therapeutic potential beyond anesthesia, including treatment-resistant depression. However, its low oral bioavailability due to extensive first-pass metabolism and high abuse potential limit outpatient use. This study describes the design, synthesis, and in vivo evaluation of a ketamine prodrug conjugated to tyrosine...