International journal of psychiatry in clinical practice
June 1, 2024
Ludovic Samalin, Lila Mekaoui, Pierre De Maricourt et al.
3 citations
An observational study of adults with treatment-resistant depression (TRD) treated with esketamine across three time periods found that patients had moderate-to-severe depression, with an average Montgomery-Åsberg Depression Rating Scale score of 32.6. The 157 treated patients (average age 49.0 years, 66.2% female) showed varied disease severity, subtypes, and comorbidities across cohorts. Later cohorts used esketamine earlier and before other treatments. The findings indicate a high burden of TRD and suggest esketamine is a potentially useful alternative, especially as clinicians gain more familiarity and access.
European journal of psychotraumatology
December 1, 2026
Maud Rothärmel, Lila Mekaoui, François Kazour et al.
1 citation
In a retrospective study of 22 adults with treatment-resistant depression and comorbid post-traumatic stress disorder who received esketamine nasal spray, trauma re-experiencing episodes occurred during treatment sessions. For 16 patients (72.7%) these episodes disappeared as sessions progressed. Treatment was stopped for 6 patients (27.3%) due to re-experiencing. Among those who continued esketamine, depression response rate was 45.5% and remission 22.7%; PTSD improvement rate was 45.5% and remission 18.2%. The findings suggest esketamine can be safely administered in this comorbid population and that trauma re-experiencing does not prevent clinical improvement.
medRxiv Preprint Server
March 31, 2026
Maia Mallevays, Louise Fuet, Michel Danon et al.
1 citation
preprint
In patients with treatment-resistant depression receiving esketamine, mystical experiences—similar to those induced by classic psychedelics—occurred in 58% of patients, with high variability across sessions. Higher mean and peak scores on the Mystical Experience Questionnaire (MEQ-30) were associated with greater improvement in depression severity, while dissociative or other non-mystical effects were not. Positive mood and mystical dimensions of the MEQ predicted therapeutic outcomes, and baseline spirituality predicted both treatment response and peak MEQ scores in the first week. These findings suggest that psychedelic-like mystical experiences may contribute to esketamine's therapeutic efficacy.
Journal of affective disorders
May 1, 2026
Michel Danon, Gabriela Ostronoff, Anne-Cécile Petit et al.
Regulatory approvals for intranasal esketamine in treatment-resistant depression differ on its indication for suicidal ideation. In a two-center observational study of 261 adults with moderate-to-severe treatment-resistant depression, eight esketamine sessions over four weeks improved both depressive symptoms and suicidal ideation. However, after statistically adjusting for the antidepressant effect, the reduction in suicidal ideation was no longer significant. The findings suggest that esketamine's anti-suicidal effect does not persist independently of its antidepressant effect.