Esketamine for Suicidality

12 papers and 8 clinical trials exploring esketamine as a treatment for suicidality.

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
Indication700,000 deaths annually worldwide.

Suicidality

Suicidality encompasses a spectrum of suicidal thoughts and behaviours, significantly impacting individuals globally. Recent research into psychedelics, particularly ketamine and ayahuasca, shows promise in rapidly alleviating suicidal ideation associated with mental health disorders.

Full Suicidality profile

Academic Research

12 papers
Open Accessindividual

Effect of Esketamine on Depressive Symptoms in Adolescents with Major Depressive Disorder at Imminent Suicide Risk: A Randomized Psychoactive-Controlled Study

This double-blind Phase IIb trial (n=147) evaluated the efficacy, safety, and tolerability of esketamine nasal spray versus midazolam in reducing depressive (MDD) symptoms in adolescents at imminent risk for suicide (SI). The study finds that pooled doses of esketamine (56 and 84 mg) significantly reduce depressive symptoms at 24 hours, with common side effects including dizziness, nausea, and dissociation.

Published
Journal
Journal of the American Academy of Child & Adolescent Psychiatry
Authors
Bloch, M. H., Canuso, C. M., Chen, L. N., DelBello, M., Drevets, W. C., Fu, D. J., Kosik-Gonzalez, C., Lane, R., Moreno, C.
Open Accessindividual

Safety and Efficacy with Esketamine in Treatment-Resistant Depression: Long-Term Extension Study

In the phase 3 SUSTAIN-3 long-term extension (1,148 patients, 3,777 patient‑years), intermittent intranasal esketamine plus an oral antidepressant showed no new safety signals and an adverse event profile consistent with earlier studies. Depression severity improved during induction and was generally maintained during optimisation/maintenance, with remission in 35.6% at induction and about 48–50% at week 112/maintenance endpoint.

Published
Journal
International Journal of Neuropsychopharmacology
Authors
Chen, L. N., Doherty, T., Drevets, W. C., Fu, D. J., Lacerda, A. L. T., Lane, R., Morrison, R. L., Paik, J.-W., Popova, V., Sanacora, G., Wilkinson, S. T., Young, A. H., Zaki, N.
Open Accessindividual

Health Care Resource Use and Medical Costs Among Patients With Major Depressive Disorder and Acute Suicidal Ideation or Behavior Initiated on Esketamine Nasal Spray or Traditional Treatments in the United States

This retrospective cohort study (n=14,912) examines healthcare resource use (HRU) and costs among patients with major depressive disorder (MDD) and acute suicidal ideation or behaviour (SI) initiated on esketamine nasal spray, ECT, SGA augmentation, or antidepressant monotherapy in the U.S. Esketamine-treated patients (n=122) had lower acute care HRU (0.59 days) and costs ($1869/month) compared to ECT (3.17 days, $4624) and SGA augmentation (0.92 days, $2163), but higher than monotherapy (0.32 days, $863). Esketamine reduced HRU (58%) and costs (50%) most significantly from baseline.

Published
Journal
Clinical Therapeutics
Authors
Boonmak, P., Harding, L., Joshi, K., Pilon, D., Shah, A., Teeple, A., Zhdanava, M.
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.
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

8 trials

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