Ketamine and Esketamine

Ketamine is a non-competitive NMDA receptor antagonist with a potent anesthetic effect. Esketamine is the S(+) enantiomer of ketamine.

• Esketamine also acts to some extent as a dopamine reuptake inhibitor but, unlike ketamine, does not interact with the sigma receptors.

• Turner, E. H. (2019). Esketamine for treatment-resistant depression: seven concerns about efficacy and FDA approval. The Lancet Psychiatry, 6(12), 977-979.
• Gastaldon, C., Raschi, E., Kane, J. M., Barbui, C., & Schoretsanitis, G. (2020). Post-Marketing Safety Concerns with Esketamine: A Disproportionality Analysis of Spontaneous Reports Submitted to the FDA Adverse Event Reporting System. Psychotherapy and Psychosomatics, 1-8.

• Psychiatry at the Margins:Is ketamine as good as placebo or as good as ECT?
• Lii, T. R., Smith, A. E., Flohr, J. R., Okada, R. L., Nyongesa, C. A., Cianfichi, L. J., ... & Heifets, B. D. (2023). Randomized trial of ketamine masked by surgical anesthesia in patients with depression. Nature Mental Health, 1(11), 876-886.
  • Rational Psychiatry: The powerful and the damned
• Schatzberg, A. F. (2019). A Word to the Wise About Intranasal Esketamine. American Journal of Psychiatry, appi-ajp.
• Horowitz MA, Moncrieff J. Are we repeating mistakes of the past? A review of the evidence for esketamine. Br J Psychiatry. 2020;1‐4. doi:10.1192/bjp.2020.89
• Cristea, I. A., & Naudet, F. (2019). US Food and Drug Administration approval of esketamine and brexanolone. The Lancet Psychiatry, 6(12), 975-977.