Comprehensive Systematic Review of Esketamine Nasal Spray as a Standalone Rapid-Acting Treatment for Treatment-Resistant Depression: Integrating Clinical Trial Data and Emerging Real-World Evidence on Efficacy, Safety, And Relapse Prevention
International Journal of Drug Delivery Technology June 30, 2026 Angelin Grace Thomas, Dhivyaprasath Palaniappan, Sagar Guruswamy et al.
Esketamine nasal spray reduces depressive symptoms more effectively than a placebo or other treatments like quetiapine for people with treatment-resistant depression. Many patients felt better within days, and some benefits lasted weeks or months after stopping treatment. Most side effects, such as dizziness, nausea, and blood pressure changes, were mild to moderate and resolved within two hours. No serious side effects or deaths were reported. Gathering patient feedback during treatment helped doctors create better care plans. Some studies had small sample sizes, and long-term effects beyond 12 months are not well documented. Ongoing phase 3 studies aim to clarify optimal dosages and long-term outcomes.