A Systematic Review and Meta-Analysis of the Efficacy and Safety of Intranasal Esketamine for Rapid Symptom Relief in Treatment-resistant Depression.
Reviews on recent clinical trials April 7, 2026 Ritika Saun, Aakriti Garg, Mohd Ashif Khan
In adults with treatment-resistant depression, intranasal esketamine plus an antidepressant improved depressive symptoms within 24 hours, as measured by the MADRS scale (average 3.44 points greater reduction than placebo). However, esketamine raised the risk of elevated blood pressure threefold and dissociation nearly sixfold. The analysis of nine randomized controlled trials supports esketamine as a fast-acting option, but short follow-up periods, varying dosing protocols, and the notable side-effect profile limit broader conclusions. Long-term safety and durability of response remain insufficiently studied.