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Home/Research/Esketamine/Anxiety Disorders

Esketamine for Anxiety Disorders

24 papers and 3 clinical trials 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

24 papers
Open Accessindividual

Intranasal esketamine in treatment-resistant depression: long-term dosing patterns and clinical outcomes in a 5-year observational study

This observational study (n=45) followed people with treatment-resistant depression for up to 5 years and found that adjunctive intranasal esketamine was linked with sustained reductions in depression scores in those who stayed on treatment. No hypomania or mania was seen, and side effects were generally low.

Published
April 20, 2026
Journal
Therapeutic Advances in Psychopharmacology
Authors
Cuomo, A., McIntyre, R., Koukouna, D., Pinzi, M., Pardossi, S., Firenzuoli, B., Barillà, G., Carmellini, P., Alamia, A., Fagiolini, A.
Paywallindividual

Efficacy and safety of esketamine for smoking cessation among patients diagnosed with lung cancer and major depression disorder: A randomized, placebo-controlled clinical trial

This multicenter, randomised, placebo-controlled clinical trial (n=236) investigates the efficacy and safety of esketamine (ESK) (8x35mg) for smoking cessation in patients with lung cancer and major depressive disorder (MDD). Eight weekly intranasal ESK sessions significantly improved both self-reported (44.1%) and biologically verified (28.8%) smoking abstinence at 6-month follow-up, alongside reductions in depression, anxiety, nicotine dependence, and respiratory symptoms.

Published
August 1, 2025
Journal
Journal of Affective Disorders
Authors
Hong, C. J.
Open Accessmeta

Control Group Outcomes in Trials of Psilocybin, SSRIs, or Esketamine for Depression: A Meta-Analysis

This meta-analysis of 17 trials found that control-group participants in psilocybin depression trials showed markedly smaller improvements (SMC ≈ 0.50) on the MADRS than control participants in SSRI (SMC ≈ 1.00) or esketamine (SMC ≈ 1.12) trials. The authors conclude this disparity may indicate that psilocybin’s antidepressant efficacy is overestimated relative to SSRIs and esketamine, possibly because of functional unblinding and expectancy effects.

Published
July 30, 2025
Journal
JAMA Network Open
Authors
Hieronymus, F., López, E., Sjögren, H. W., Lundberg, J.
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
April 25, 2025
Journal
Journal of Psychopharmacology
Authors
Veraart, J. K. E., Smith-Apeldoorn, S. Y., van der Meij, A., Spijker, J., Schoevers, R. A., Kamphuis, J.
Paywallindividual

Barriers to Esketamine Nasal Spray Treatment Among Adults With Treatment-Resistant Depression

This retrospective observational cohort study (n=966 esketamine initiators, n=39,219 controls) examines factors influencing esketamine initiation and continuation for treatment-resistant depression (TRD). Initiators resided closer to treatment centres, with initiation rates decreasing significantly with distance. Factors associated with increased initiation included posttraumatic stress disorder, suicidal ideation, and male sex, while Medicaid, substance use disorder, older age, and greater distance were associated with lower initiation rates.

Published
May 6, 2024
Journal
Journal of Clinical Psychiatry
Authors
Joshi, K., Liberman, J. N., Parab, P., Darer, J. D., Harding, L.
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
May 1, 2024
Journal
Child and Adolescent Psychiatry
Authors
Zhou, Y., Lan, X-F., Wang, C., Zhang, F., Liu, H., Chao, Z., Ning, Y-P., Fu, L., Hu, Z., Li, W., Ye, Y.

Clinical Trials

3 trials
Not yet recruitingPhase I

Effect of sub - anesthetic dose of esketamine on the incidence of postoperative anxiety and depression in patients with thyroid cancer and breast cancer: A prospective, single - center clinical study

This prospective, single-centre interventional trial in China (n=196 planned; 98 per group) is a Phase 0 parallel-group study evaluating whether subanaesthetic esketamine reduces postoperative anxiety and depression in adults undergoing surgery for thyroid cancer or breast cancer. Participants are randomised to receive either an esketamine infusion prepared at 2.5 mg/ml and administered at 0.25 mg/kg/h, or 0.9% normal saline at 0.1 ml/kg/h as the control comparator. The study population includes both sexes aged 18 years and older. The primary outcome is the incidence of postoperative anxiety and depression in both groups within 72 hours after surgery. Secondary outcomes include postoperative quality of recovery, assessed using the QoR-15 at 48 hours, postoperative pain scores at 48 and 72 hours, and healthcare utilisation measures including length of hospital stay and total cost from surgery to discharge. The trial is designed to assess whether perioperative esketamine can improve early psychological and recovery outcomes in patients with cancer surgery.

Started
March 20, 2026
Type
interventional
Blinding
none
Randomized
No
Registry ID
ChiCTR2600120238
Not yet recruitingPhase IV

Effects of different doses of esketamine on postoperative delirium and postoperative cognitive function in elderly gastrointestinal tumor patients with preoperative anxiety

This parallel, Phase 4 interventional trial in China (n=136) is investigating the effects of different doses of esketamine on postoperative delirium and postoperative cognitive function in elderly patients with gastrointestinal tumours who have preoperative anxiety. Participants aged 60 to 80 years, of both sexes, are being assigned to one of three esketamine dose groups (0.15 mg/kg, 0.25 mg/kg, or 0.5 mg/kg) or a placebo control group. The study is designed to compare whether lower or higher perioperative doses of esketamine influence neurocognitive recovery after surgery. The primary outcomes are postoperative delirium and postoperative cognitive function, assessed after the operation; the registry record does not specify the exact assessment timepoints. Secondary outcomes include anxiety, haemodynamic adverse events, intraoperative vital signs, postoperative pain, intraoperative propofol and remifentanil requirements, emergence agitation, and serum concentrations of interleukin-6, S100ß, and neuron-specific enolase. Sponsored by The Central Hospital of Wuhan, this trial reflects ongoing clinical research in China evaluating esketamine as a potential perioperative adjunct in older surgical patients at risk of neurocognitive complications.

Started
August 1, 2025
Type
interventional
Blinding
none
Randomized
No
Registry ID
ChiCTR2500106981
Unknown statusPhase I

Effect of Esketamine on Reducing Postoperative Anxiety and Depression in Adolescent Patients

Double-blind, randomised, controlled perioperative trial (n=200) evaluating a single subanesthetic esketamine dose to reduce postoperative anxiety and depression in adolescents undergoing elective surgery.

Started
October 10, 2023
Type
interventional
Blinding
double
Randomized
Yes
Registry ID
NCT06073015

Explore further

Search all Esketamine papers Search all Anxiety Disorders trials Full Esketamine profile Full Anxiety Disorders profile