Intranasal Esketamine Reduces Depression and Suicidality, Modestly and Briefly

Intravenous ketamine reduces symptoms of depression and suicidality for up to several weeks, but less is known about the non–FDA-approved intranasal form. In an industry-funded, 4-week, double-blind, randomized multicenter trial, researchers tested the adjunctive effects of twice-weekly intranasal esketamine or matching placebo in 66 acutely suicidal, depressed patients meriting hospitalization at presentation.

The clinically indicated hospitalizations typically lasted 5 days. As outpatients, participants received twice-weekly visits including antidepressant management (monotherapy or polypharmacy). Exclusions included bipolar disorder, moderate-to-severe substance use disorder, present or past psychosis, and borderline or antisocial persona…