The Emerging Role of Ketamine and Esketamine in the Concurrent Management of Pain and Depression in Cancer Patients: Evidence and Implications for Practice
Journal of Pain & Palliative Care Pharmacotherapy December 27, 2025 Shannon Moriarty, Anna Dushenkov, Kathleen M. Frey
Ketamine and its S-enantiomer esketamine, which modulate glutamate via N-methyl-D-aspartate receptor antagonism, may simultaneously relieve pain and depression in cancer patients, conditions usually treated separately. A review of ten clinical studies from 2018 to 2024 found promising but mixed evidence. Two randomized controlled trials in post-surgical breast and cervical cancer patients showed intravenous esketamine and racemic ketamine improved both pain and depression, with esketamine providing greater and longer-lasting benefit.