Esketamine Nasal Spray in Major Depressive Disorder: A Meta-Analysis of Randomized Controlled Trials.
Clinical pharmacology and therapeutics June 1, 2025 Zhibin Wang, Lili Jiang, Wenzhuang Ma et al. 8 citations
A systematic review and meta-analysis of randomized controlled trials found that esketamine nasal spray, when used alongside an antidepressant, reduces depressive symptoms more than placebo in people with major depressive disorder. In patients without suicidal thoughts, symptoms improved by day 28; in those with suicidal thoughts, improvement was seen by day 2. Long-term relapse rates were 40% lower with esketamine than with placebo or quetiapine. The rate of suicidal ideation was similar between groups. The evidence was rated moderate to high certainty. Esketamine nasal spray appears to effectively control short- and long-term depressive symptoms with a manageable balance of benefits and risks.