Is there a risk of esketamine misuse in clinical practice?
Therapeutic advances in drug safety January 1, 2025 Carlos Roncero, Milton Merizalde-Torres, Néstor Szerman et al. 11 citations
Intranasal esketamine, approved in 2019 for treatment-resistant depression, effectively alleviates depressive symptoms with benefits lasting nearly 4.5 years. Long-term clinical studies, case reports, and subsamples of high-risk populations with substance use or alcohol use disorder have not documented abuse, misuse, addiction, or withdrawal. Esketamine is safe and well tolerated without fostering new-onset substance use. Real-world studies report no adverse events from pharmacological interactions and no new-onset drug or alcohol misuse, craving, misuse, or diversion. Only one case report of esketamine craving exists (2022). No illicit acquisition or tampering was found. The review confirms esketamine's safety and the scarcity of abuse or misuse reports.