Intravenous Ketamine in Psychiatry: Therapeutic Applications, Mechanisms of Action, and Clinical Perspectives
Open Minds International Journal July 6, 2026 Juliana Leite Haubman, João Octávio Celante da Silva, Bruno Horta Leonardo Machado de Moura et al.
Intravenous esketamine, derived from the S-enantiomer of ketamine, acts primarily as an NMDA receptor antagonist, promoting rapid glutamatergic modulation and brain neuroplasticity. A narrative literature review of articles published between 2015 and 2026 indicates that intravenous ketamine produces a rapid antidepressant response, with significant improvement in symptoms among patients with treatment-resistant depression and severe conditions linked to suicidal ideation. Benefits are also reported for anxiety disorders, bipolar disorder, and suicide prevention. However, adverse effects such as dissociation, transient blood pressure elevation, nausea, and abuse potential remain significant limitations. Further long-term studies are needed to establish safe, standardized protocols.