Esketamine treatment for depression in adults: a systematic review and combined analysis
Updated
Abstract
Of 1,115 articles initially identified, 87 were included for analysis and discussion.
- Randomized controlled trials at weeks 2-4 mostly showed negative or failed outcomes.
- A meta-analysis indicated a weak but significant positive effect for depression (effect size range, 0.15-0.23).
- The effect size related to suicidality was not significant at any time point.
- Esketamine's efficacy as an add-on to antidepressants is modest when compared to augmentation strategies with atypical antipsychotics.
- Concerns regarding esketamine's abuse potential and unknown long-term effects were noted, along with alarming signs of deaths and emerging suicidality during testing.
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Funding
Competing interests
Dr. Saitis has received support to participate in congresses from Innovis Pharma and Ricordatti. Dr. Schatzberg has served as a consultant for Alto Neurosciences, ANeurotech, Delpor, Douglas Pharmaceuticals, Galen, HMNC, Johnson & Johnson, Magnus, Mindful Health Solutions, NeuraWell, Owl Insights, Sage, Skyland Trail, Soneira, and Tris; and he has equity in Alto Neurosciences, ANeurotech, Corcept, Madrigal, Magnus, Mindful Health Solutions, NeuraWell, Seattle Genetics, Soneira, and Titan. Dr. Fountoulakis reports no financial relationships with commercial interests.
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