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The following is a summary of “Esketamine Treatment for Depression in Adults: A PRISMA Systematic Review and Meta-Analysis,” published in the January 2025 issue of Psychiatry by Fountoulakis et al.
Esketamine is approved as adjunctive therapy for treatment-resistant depression with suicidal ideation.
Researchers conducted a retrospective study on the efficacy of intranasal esketamine for depression, suicidality, and side effects.
They searched MEDLINE for “esketamine” on March 24, 2024, using PRISMA. Analysis was performed with R 4.3.3 and the METAFOR package.
The results showed that 87 of 1,115 articles were included for analysis. Randomized controlled trials at weeks 2–4 were mostly negative, with a weak but significant effect for depression (effect size 0.15–0.23). The effect on suicidality was not significant. The sensitivity analysis showed the same results.
Investigators found that esketamine’s efficacy as an add-on to antidepressants was modest in treatment-resistant depression and absent against suicidality. Concerns about abuse potential, long-term effects, and emerging suicidality during testing were also highlighted.
Source: psychiatryonline.org/doi/10.1176/appi.ajp.20240515
