Esketamine: new hope for the treatment of treatment-resistant depression? A narrative review.
Therapeutic advances in drug safety January 1, 2020 Mohammed S Salahudeen, Cameron M Wright, Gregory M Peterson
Intranasal esketamine, the S-enantiomer of ketamine, is effective and safe for reducing depressive symptoms and achieving clinical response in patients with treatment-resistant depression (TRD). About a third of patients with major depressive disorder fail to achieve remission despite multiple antidepressants. The optimum duration and frequency of use are not fully understood. Although the nasal spray is convenient, its use may be limited by cost and administrative regulation. Further long-term data and comparative trials with the R-isomer (arketamine) are needed, and care and monitoring should be exercised in clinical practice.