ADVERSE EFFECTS OF ESKETAMINE IN TREATMENT RESISTANT DEPRESSION: A COMPREHENSIVE LITERATURE REVIEW (2020-2025)
International Journal of Innovative Technologies in Social Science February 16, 2026 Aleksandra Lejman, Rafał Bednarczyk, Natalia Bednarczyk et al.
Esketamine nasal spray, the first novel mechanism treatment for treatment-resistant depression in decades, has an acceptable safety profile under clinical supervision. Common adverse effects such as dissociation and sedation resolve within two hours, and blood pressure elevations normalize within 1.5 hours without intervention. Pre-approval concerns about bladder cystitis, cognitive decline, and abuse were not confirmed: no cystitis occurred despite years of exposure, cognitive function remained stable or improved, and misuse was rare (less than 0.01%). Serious adverse events were infrequent (less than 0.2% of sessions), mainly during initial treatments. Mortality rates matched background rates in treatment-resistant depression. Long-term studies up to 6.5 years found no organ damage, cognitive decline, or meaningful abuse problems.