The Efficacy and Safety of Intranasal Formulations of Ketamine and Esketamine for the Treatment of Major Depressive Disorder: A Systematic Review
Pharmaceutics December 22, 2023 Ludivine Boudieu, Myriam Mennetrier, Pierre-Michel Llorca et al. 22 citations
Intranasal ketamine and esketamine offer a rapid onset of antidepressant effects within hours for people with major depressive disorder, particularly those with treatment-resistant depression or active suicidal thoughts. A systematic review following PRISMA guidelines found stronger evidence of efficacy for intranasal esketamine than for intranasal ketamine. The safety profile of intranasal esketamine appears acceptable, though further studies are needed; a more accurate delivery device is required for ketamine. These glutamatergic agents bypass the blood–brain barrier, potentially reducing side effects compared with intravenous administration.