COMPARING ROUTES OF KETAMINE ADMINISTRATION IN TREATMENT-RESISTANT DEPRESSION: EFFICACY, SAFETY, AND OPTIMIZATION OF DOSING STRATEGIES
International Journal of Innovative Technologies in Social Science June 24, 2026 Irmina Grygutis, Oskar Mikołajczyk, Kornelia Julia Fimiarz et al.
Ketamine and its derivative esketamine are rapid-acting treatments for treatment-resistant depression, but the best way to give them depends on balancing effectiveness, safety, cost, and available healthcare resources. Intravenous (IV) ketamine works fastest and most strongly but requires infusion equipment and monitoring for temporary high blood pressure and dissociation. FDA-approved intranasal esketamine has strong long-term data but needs supervised in-clinic administration and blood pressure checks. Oral and sublingual forms are easier and cheaper but less effective and carry higher risk of misuse. Subcutaneous and intramuscular injections offer high absorption with minimal setup but have little supporting evidence. The choice of route should be tailored to each patient's situation.