First study to compare ketamine therapies for patients with severe depression - Harvard Gazette

"In a new study, investigators compared the effects of repeated intravenous (IV) ketamine and intranasal (IN) esketamine in patients with treatment-resistant depression and found both reduced depression severity, with IV ketamine showing relatively earlier and greater improvements. Led by researchers at Harvard-affiliated Mass General Brigham, the study was published in the Journal of Clinical Psychiatry. The research was based on retrospective analysis of data from 153 adult patients being treated at McLean Hospital for severe treatment-resistant depression."

"Nearly 30 percent of patients with major depressive disorder fail to respond to two or more antidepressants, necessitating multiple strategies to manage their symptoms. Recently, intranasal esketamine - a subcomponent of ketamine - has emerged as a promising treatment for this challenging condition and is an FDA-approved antidepressant for adults. By contrast, IV ketamine, initially approved by the FDA as an anesthetic, remains an off-label treatment option despite decades of clinical research that demonstrates its antidepressant effects."

"Researchers evaluated efficacy and rapidity of therapeutic responses in 111 patients who received IV ketamine and 42 patients who received IN esketamine, administered twice weekly over four to five weeks for a total of eight treatments during the induction treatment phase. "We examined data naturally accumulated from patients over the course of clinical work, in one of the largest naturalistic comparison of the two drugs to date,""

Repeated intravenous (IV) ketamine and intranasal (IN) esketamine were compared in 153 adults with severe treatment-resistant depression. IV ketamine was administered to 111 patients and IN esketamine to 42 patients, both given twice weekly for four to five weeks for eight induction treatments. Both treatments produced significant reductions in depression severity from pretreatment baseline after the final induction session. IV ketamine produced relatively earlier and greater improvements in depressive symptoms compared with IN esketamine. Intranasal esketamine is FDA-approved for adults, while IV ketamine remains an off-label antidepressant despite decades of supporting clinical research.

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