Ketamine in Treatment-Resistant Depression

Abstract

Ketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist that has antidepressant and antisuicidal effects, as shown by multiple studies done over the past two decades, that can be used effectively in the management of treatment-resistant depression (TRD). The United States Food and Drug Administration has approved intranasal (S)-ketamine in combination with an oral antidepressant for TRD. Although research is promising with respect to ketamine's effect on depression and suicidality, the need for in-office administration and treatment monitoring limits the accessibility of treatment. Significant concerns remain regarding the risks of treatment and its abuse potential. Nonetheless, its potential efficacy in TRD and suicidality makes ketamine an effective treatment modality for this patient population. [ Psychiatr Ann . 2024;54(6):e170–e176.]