[Intravenous Subnarcotic Ketamine Infusions for Treatment-Resistant Depression: Historical Development, Comparison with Esketamine Nasalspray, and Prospects].
Fortschr Neurol Psychiatr June 8, 2026 Udo Bonnet, Norbert Scherbaum, Georg Juckel et al.
Ketamine, administered intravenously at subnarcotic doses, has emerged as a rapid-acting treatment for treatment-resistant depression. This historical overview traces its development, compares it with the newer esketamine nasal spray, and discusses future prospects. Intravenous ketamine infusions have shown efficacy in rapidly reducing depressive symptoms, while esketamine, a derivative, offers a more convenient nasal route but may have different efficacy and safety profiles. The article highlights the need for further research to optimize dosing, duration of effect, and long-term outcomes, as well as to understand the mechanisms underlying ketamine's antidepressant action.