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Esketamine monotherapy efficacious in treatment‐resistant depression

The Brown University Psychopharmacology Update November 1, 2025 Peer reviewed DOI: 10.1002/pu.31369

Summary

Intranasal esketamine administered twice weekly significantly improved depressive symptoms in adults with treatment-resistant depression compared to a placebo over a 4-week trial. Both doses of 56 mg and 84 mg were effective in outperforming the placebo group.

Study at a glance

Design randomized controlled trial
Population adults with treatment-resistant depression
Key finding Twice-weekly dosing of intranasal esketamine led to significant improvement in depressive symptoms compared to placebo.

Abstract

Twice‐weekly dosing of intranasal esketamine resulted in significant improvement in depressive symptoms compared with placebo in adults with treatment‐resistant depression, a 4‐week trial has found. Esketamine doses of 56 and 84 mg both outperformed ­placebo in the post‐marketing trial. Study results were published online July 2, 2025, in JAMA Psychiatry.

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