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Pharmacotherapy: Ketamine and Esketamine
Anna Feeney1, George I Papakostas1
1Department of Psychiatry, Clinical Trials Network and Institute, Massachusetts General Hospital, One Bowdoin Square, 9th Floor, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA.
Abstract:
Ketamine and esketamine have rapid-onset antidepressant effects and may be considered for the management of treatment-resistant depression. Intranasal esketamine has regulatory approval in the United States and European Union. Intravenous ketamine is often administered off-label as an antidepressant, though no standard operating procedures exist. Repeated administrations and the use of a concurrent standard antidepressant may maintain antidepressant effects of ketamine/esketamine. Possible adverse effects of ketamine and esketamine include psychiatric, cardiovascular, neurologic and genitourinary effects, and the potential for abuse. The long-term safety and efficacy of ketamine/esketamine as antidepressants require further study.
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