Ketamine-Assisted Psychotherapy

Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study

Popova V, Daly EJ, Trivedi M, et al. · American Journal of Psychiatry, 2019

This phase 3 trial, run at 39 outpatient centers, studied esketamine, a nasal-spray form related to ketamine, in adults with moderate to severe depression who had not responded to at least two antidepressants. Of 227 randomized participants, one group started esketamine twice weekly plus a new oral antidepressant, and the other started the new antidepressant plus a placebo spray, in a double-blind design. In this study, depression scores at day 28 improved more in the esketamine group, with a difference of about 4 points on the rating scale. Dissociation, nausea, vertigo, altered taste and dizziness were more common with esketamine and usually settled within 1.5 hours. A limitation is the short four-week window of the main comparison.

Our summaries describe what each study found. They are not medical advice, and the practices at Halcyon are not a treatment for any condition.