Intravenous ketamine versus esketamine for depression: a systematic review and meta-analysis.
Therapeutic advances in psychopharmacology January 1, 2025 Ahmed Elmosalamy, Idil Tarikogullari, Liliana Patarroyo-Rodriguez et al. 7 citations
About one-third of people with depression do not respond to standard treatments, a condition known as treatment-resistant depression (TRD). Intravenous (IV) ketamine and esketamine (given IV or as a nasal spray) are newer options for TRD, but only the nasal spray version of esketamine is FDA-approved. A meta-analysis of eight studies with 978 adults directly comparing IV ketamine with esketamine found that both treatments produced similar rates of response and remission after acute treatment, with a slight but not statistically significant advantage for IV ketamine. IV ketamine may work faster, but the evidence is mostly from observational studies, and large randomized trials are needed to confirm these findings.