Ketamine and Esketamine in Depression: Current Evidence on Mechanisms, Efficacy, Safety and Clinical Use – A Review
Journal of Education Health and Sport June 22, 2026 Urszula Szuleta, Wiktoria Zawada, Krystian Kaczmarek et al.
Major depressive disorder often resists current treatments; a reanalysis of the STAR*D study found a cumulative remission rate of about 41% after up to four treatment steps. Ketamine and its derivatives have attracted attention for their rapid antidepressant effects, especially in treatment-resistant depression. This review summarizes evidence on their efficacy, safety, and clinical use. Ketamine appears promising due to its fast onset of action, and some evidence suggests it may reduce suicidal ideation in high-risk patients. However, the authors emphasize the need for further large-scale, long-term studies to clarify the durability of benefit and long-term safety.