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Home/Research/Esketamine/Substance Use Disorders (SUD)

Esketamine for Substance Use Disorders (SUD)

7 papers and 1 clinical trial exploring esketamine as a treatment for substance use disorders (sud).

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
IndicationOver 2% of the global population is affected by some form of substance use disorder, contributing to nearly 12 million deaths annually.

Substance Use Disorders (SUD)

Substance use disorders (SUDs) are complex conditions marked by compulsive substance use despite negative consequences. Recent research is exploring the therapeutic potential of various psychedelics, including LSD, psilocybin, and MDMA, in treating these disorders to provide novel, effective treatment options.

Full Substance Use Disorders (SUD) profile

Academic Research

7 papers
Paywallindividual

Real-World Safety of Esketamine Nasal Spray: A Comprehensive Analysis Almost 5 Years After First Approval

This real-world safety analysis of esketamine in the United States (n=58,483 patients, 1,486,213 treatment sessions over 58 months) found that sedation, dissociation, and increased blood pressure occurred in 34.7%, 41.0%, and 0.9% of sessions respectively, with serious adverse events in <0.1-0.18% of sessions, suicide rates lower than background rates, and 210 cases of abuse/misuse reported, confirming the established safety profile with no new safety signals identified.

Published
October 1, 2025
Journal
American Journal of Psychiatry
Authors
Sanacora, G., Ahmed, M., Brown, B., Cabrera, P., Doherty, T., Himedan, M., Kern, D. M., Lim, L., Lopena, O., Naranjo, R. R., Nuamah, I., Sarayani, A., Turkoz, I., Bowrey, H. E.
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 Accessindividual

Esketamine combined with a mindfulness-based intervention for individuals with alcohol problems

In a double-blind, randomised pilot study of 28 people with alcohol problems, sublingual esketamine (115.1 mg) combined with two weeks of daily mindfulness-based intervention increased psychological engagement with the practice and produced transient reductions in alcohol craving versus placebo. Esketamine also elicited greater mystical and dissociative experiences, suggesting these altered states may underlie enhanced engagement and potential therapeutic benefit.

Published
June 11, 2024
Journal
Journal of Psychopharmacology
Authors
Gent, E. M., Bryan, J. W., Cleary, M. A., Clarke, T. I., Holmwood, H. D., Nassereddine, R. O., Salway, C., Depla, S., Statton, S., Krecké, J., Morgan, C. 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

The correlation of Esketamine with specific adverse events: a deep dive into the FAERS database

This retrospective analysis (n=5061) of FAERS data on esketamine from 2019 to 2023 reveals 117 adverse reactions. In addition to known adverse events, new signals like flashback, tachyphylaxis, and autoscopy were identified. Suicidal ideation and attempts were relatively high, emphasizing the need for vigilance, while issues related to nasal administration, such as monitoring procedure errors and discomfort, were highlighted.

Published
December 16, 2023
Journal
European Archives of Psychiatry and Clinical Neuroscience
Authors
Jiang, Y., Du, Z., Shen, Y., Zhou, Q., Zhu, H.
Paywallmeta

Ensuring the affordable becomes accessible-lessons from ketamine, a new treatment for severe depression

The paper uses ketamine as a case study to show that market and regulatory failures allowed a costly patented intranasal s‑ketamine (Spravato®) to be commercialised while inexpensive generic racemic ketamine—apparently at least as effective—remained under‑evaluated and largely inaccessible. The authors recommend systemic reforms, including commercial incentives, public and public–private funding, reduced regulatory barriers and coordinated international funding, to ensure affordable off‑patent treatments become accessible.

Published
October 13, 2023
Journal
Australian and new-zealand Journal of Psychiatry
Authors
Rodgers, A., Bahceci, D., Davey, C. G., Chatterton, M. L., Glozier, N., Hopwood, M., Loo, C.

Clinical Trials

1 trial
CompletedPhase II

Esketamine (AWKN002) Combined with Mindfulness-Based Intervention for Alcohol Use Disorder: A Double-Blind Pilot RCT (Gent 2024, University of Exeter)

This unregistered trial (n=28) was a double-blind, placebo-controlled pilot RCT of esketamine combined with mindfulness-based intervention for alcohol use disorder in adults, which found that esketamine enhanced psychological engagement and transiently reduced alcohol cravings.

Started
January 1, 2021
Type
interventional
Blinding
double
Randomized
Yes
Registry ID
GENT-2024-JPP-ESKETAMINE-AUD-EXETER

Explore further

Search all Esketamine papers Search all Substance Use Disorders (SUD) trials Full Esketamine profile Full Substance Use Disorders (SUD) profile