Esketamine for Anxiety Disorders

11 papers and 1 clinical trial exploring esketamine as a treatment for anxiety disorders.

Compounddissociative

Esketamine

Esketamine (Spravato) is the S-enantiomer of ketamine, approved as an intranasal treatment for treatment-resistant depression and MDD with acute suicidal ideation. It is administered under clinical supervision with post-dose monitoring and has reached over $1.6 billion in annual sales.

Full Esketamine profile
Indication300 million worldwide

Anxiety Disorders

Anxiety disorders, affecting around 300 million people globally, are among the most prevalent mental health conditions. Emerging clinical research suggests that various psychedelics, including psilocybin, MDMA, and LSD, hold potential for alleviating anxiety symptoms through innovative therapeutic approaches.

Full Anxiety Disorders profile

Academic Research

11 papers
Open Accessindividual

Oral esketamine for patients with severe treatment-resistant depression: Effectiveness, safety, and tolerability of a six-week open-label treatment program

In a naturalistic open‑label study of 185 adults with severe treatment‑resistant depression, twice‑weekly individually titrated oral esketamine for six weeks significantly reduced depressive symptoms (HDRS‑17 mean 21.2→15.8, p<0.001) with MCID 47.1%, response 26.8% and remission 15.6%, and a low dropout rate (7.6%). Treatment was generally well tolerated with frequent but manageable side effects and no significant urinary or cognitive adverse effects, suggesting oral esketamine is a safe, patient‑friendly option with effectiveness comparable to other administration routes.

Published
Journal
Journal of Psychopharmacology
Authors
Kamphuis, J., Schoevers, R. A., Smith-Apeldoorn, S. Y., Spijker, J., van der Meij, A., Veraart, J. K. E.
Paywallindividual

Effect of Repeated Intravenous Esketamine on Adolescents With Major Depressive Disorder and Suicidal Ideation: A Randomized Active-Placebo-Controlled Trial

This placebo-controlled trial (n=54) investigates the efficacy and safety of esketamine (iv, 17.5mg, 3x) in adolescents suffering from depression (MDD) and suicidal ideation (SI). It shows significant reductions in Columbia Suicide Severity Rating Scale (C-SSRS) Ideation and Intensity scores and Montgomery-Åsberg Depression Rating Scale (MADRS) scores in the esketamine group compared to the midazolam (placebo) group at day six, with maintained antisuicidal and antidepressant responses at four weeks post-treatment.

Published
Journal
Child and Adolescent Psychiatry
Authors
Chao, Z., Fu, L., Hu, Z., Lan, X-F., Li, W., Liu, H., Ning, Y-P., Wang, C., Ye, Y., Zhang, F., Zhou, Y.
Paywallmeta

A comparison between psilocybin and esketamine in treatment-resistant depression using number needed to treat (NNT): A systematic review

This systematic review (s=5) of randomised controlled trials (RCTs) compares oral psilocybin (25mg) and intranasal esketamine (56-84mg) with an oral antidepressant in adults with depression (TRD). The review showed significant depressive symptom reduction with psilocybin (Number Needed to Treat; NNT=5) and esketamine (NNT=7). Psilocybin has a Number Needed to Harm (NNH) of 5 for nausea, while esketamine induces mild side effects (NNH<10).

Published
Journal
Journal of Affective Disorders
Authors
Cao, B., D'Andrea, G., Di Vincenzo, J. D., Ho, R., Kwan, A. T. H., Le, G. H., McIntyre, R. S., Meshkat, S., Rosenblat, J. D., Teopiz, K. M., Wong, S.
Open Accessindividual

Effects of esketamine on patient-reported outcomes in major depressive disorder with active suicidal ideation and intent: a pooled analysis of two randomized phase 3 trials (ASPIRE I and ASPIRE II)

Pooled data from ASPIRE I and II indicate that esketamine nasal spray plus standard of care produced greater patient‑reported improvements in health‑related quality of life and treatment satisfaction than placebo plus standard of care in adults with major depressive disorder and active suicidal ideation. The benefit was statistically significant on the QLDS (LS mean difference −3.1, 95% CI −5.21 to −1.02), with non‑significant change on the Beck Hopelessness Scale and favourable trends on EQ‑5D‑5L indices and TSQM‑9 domains.

Published
Journal
Quality of Life Research
Authors
Canuso, C. M., Fu, D. J., Ionescu, D. F., Jamieson, C., Lane, R., Molero, P., Qui, X., Rozjabek, H.

Clinical Trials

1 trial

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