TY - JOUR AU - Rattanasumawong, Wanida AU - Ittasakul, Pichai PY - 2020/06/25 Y2 - 2024/03/28 TI - Efficacy and Safety of Ketamine and Esketamine for the Treatment of Major Depressive Disorder JF - Journal of the Psychiatric Association of Thailand JA - J Psychiatr Assoc Thailand VL - 65 IS - 2 SE - Original Articles DO - UR - https://he01.tci-thaijo.org/index.php/JPAT/article/view/243557 SP - 179-190 AB - <p>Background : Accumulated data have confirmed ketamine’s and Esketamine’s<br>antidepressant effects. On March 2019 the U.S. Food and Drug Administration (FDA)<br>approved esketamine nasal spray in conjunction with an oral antidepressant for<br>treatment resistant depression (TRD). However, as it is used in the real world, more data<br>will be required.<br>Objective : This paper will shortly review current data focused on the efficacy and<br>safety of Ketamine and Esketamine as a treatment for TRD.<br>Methods : A literature search was conducted using the following databases: MEDLINE,<br>Embase, PubMed, and the Cochrane Library for articles published between 2000-2019.<br>The search was limited to articles written in English and Thai languages, using keywords:<br>Ketamine, Esketamine, Arketamine, Treatment resistant depression.<br>Result : Ketamine and Esketamine appear to be effective treatments when combined<br>with oral antidepressants in patients with TRD. The special effect of esketamine is<br>rapid onset of antidepressant activity; a significant benefit for high-risk suicidal patients.<br>Esketamine, an enantiomer of ketamine, works as a more potent NMDA receptor<br>antagonist. Moreover, a number of studies have suggested that esketamine has lower<br>side effects than Ketamine. Evidence underpinning esketamine’s FDA approval (based<br>on 29 studies) shows greater efficacy than currently available adjunctive medications.<br>However, the FDA asked for 3 years follow-up from esketamine trials and implemented<br>a risk and benefit assessment. More adverse events were reported from esketamine<br>when compared with placebo, but generally most of the adverse events resolved the<br>same day.<br>Conclusion : Ketamine and Esketamine show great benefit and may be an alternative<br>medication for TRD. However, future study should be conducted to gather more data<br>to address safety, efficacy and tolerability.</p> ER -