Esketamine for Depression: From Therapeutic Characteristics to Efficacy and Safety
MedScien October 23, 2025 Ziteng Qiu
Depression affects over 280 million people worldwide. Conventional antidepressants like SSRIs can take weeks to work and fail for about 30% of patients, leaving urgent needs unmet, especially for those at risk of suicide. Esketamine, the S-enantiomer of ketamine, binds more strongly to NMDA receptors than its counterpart and rapidly relieves depressive symptoms and suicidal ideation. It has shown therapeutic potential across several depression subtypes, including major depressive disorder with suicidal behavior, postpartum depression, treatment-resistant depression, bipolar depression, and atypical depression. Combining esketamine with oral antidepressants may improve outcomes. Future research should assess long-term safety, dependence risks, and biomarkers for treatment response.