Patient-centred education for ketamine and esketamine therapies in mood disorders

Treatment-resistant depression (TRD) and bipolar depression (TRBD) are severe, heterogeneous mood disorders associated with substantial functional impairment, elevated suicide risk and persistent unmet treatment needs. While pharmacological and psychological interventions continue to advance, many patients experience delayed, partial or unsustained benefit, underscoring the need for therapies with novel mechanisms and rapid onset of action. Ketamine and esketamine have emerged as distinctive treatments in this context, demonstrating rapid antidepressant and anti-suicidal effects, yet differing fundamentally from conventional antidepressants in their acute subjective effects, physiological profile, delivery models and misuse potential. This narrative review synthesizes evidence from regulatory guidance, clinical trials, observational studies and qualitative research to identify key patient information needs and propose practical psychoeducational strategies. Core elements include explanations of indications, mechanisms and treatment algorithms; guidance on visit preparation, scheduling and monitoring; management of acute adverse effects; counselling on suicidality and substance misuse; and tailored considerations for special populations, including older adults, women of reproductive potential and medically complex patients. Drawing on this synthesis, the review proposes a patient-centred framework for ketamine and esketamine psychoeducation, outlining key informational domains and practical tools that can be embedded within clinical services, and identifies priorities for future research aimed at optimizing patient experience and supporting the responsible integration of ketamine-based therapies into mood disorder care.