Prescribing bias and adverse outcomes of esketamine in major depression comorbid substance.
Journal of affective disorders November 1, 2026 Dian-Jeng Li, Tien-Wei Hsu, Te-Chang Changchien et al.
Patients with major depressive disorder who are prescribed esketamine have higher rates of comorbid substance use disorders compared to those treated with antidepressants or repetitive transcranial magnetic stimulation. Among esketamine users, those with a substance use disorder face greater risks of self-harm, suicide attempt, emergency visits, hospitalization, and mortality. The findings indicate a prescription bias toward patients with comorbid substance use disorders and highlight the need for careful monitoring and specialized care for this population.