Journal of Clinical Psychiatry
February 1, 2023
Balwinder Singh, S. Kung, Vanessa K. Pazdernik et al.
64 citations
In adults with treatment-resistant depression, intravenous (IV) ketamine and intranasal (IN) esketamine produced similar rates of symptom improvement and remission, but remission was reached in fewer treatment sessions with IV ketamine. Over up to six IV or eight IN treatments, depressive symptoms were measured before and 24 hours after each session. Among 62 participants (median age 50, 65% female), neither the change in symptom scores nor the proportion achieving response or remission differed significantly between groups. However, time to remission—adjusting for age, sex, body mass index, and baseline severity—was five times faster with IV ketamine than with IN esketamine. A randomized controlled trial is needed to confirm these results.
Journal of Clinical Psychiatry
July 13, 2021
J. Veraart, S. Smith-Apeldoorn, J. Spijker et al.
31 citations
Ketamine is known to have rapid antidepressant effects, but patients with psychotic features are usually excluded from treatment studies due to concerns that ketamine might worsen psychosis. This systematic review examined nine reports (pilot studies and case reports) involving 41 patients with a history of psychosis or current psychotic symptoms who received ketamine for depression or negative symptoms. The findings suggest that short-term ketamine treatment can be both safe and effective in this group, with side effects that were mild and self-limiting. The available evidence does not support the assumption that ketamine exacerbates psychotic symptoms in predisposed patients, although data are limited and further trials are needed.
Journal of Clinical Psychiatry
September 22, 2025
Robert C. Meisner, Shuang Li, Brian W. Boyle et al.
5 citations
In patients with severe treatment-resistant depression, intravenous racemic ketamine produced a faster and larger reduction in depressive symptoms than intranasal esketamine. Over eight treatment sessions, those receiving IV ketamine showed a 49.22% decrease in depression scores, compared to a 39.55% decrease with intranasal esketamine. The IV group showed significant improvement after just one treatment, while the intranasal group required two treatments. Both treatments were effective, but IV ketamine was associated with greater overall efficacy and more rapid response.