Ketamine vs Esketamine for Depression: Systematic Review Compares Effectiveness
Which works better: ketamine or esketamine for depression?
Intravenous ketamine shows superior efficacy compared to esketamine for treatment-resistant depression with faster onset and stronger effects. Meta-analysis reveals important differences between these ketamine treatments.
Both treatments work by blocking NMDA receptors and promoting neuroplasticity, but IV ketamine's superior bioavailability and dosing may explain its stronger antidepressant effects.
What the data show:
- Against esketamine: IV ketamine shows superior response rates
- Time to improvement: IV ketamine works more rapidly than nasal esketamine
- Effect magnitude: greater depression improvement with IV ketamine
- Target population: both effective for treatment-resistant cases, but ketamine shows advantage
- Administration: IV delivery may provide better bioavailability
A systematic review and meta-analysis published in Therapeutic Advances in Psychopharmacology directly compared intravenous ketamine and esketamine for depression treatment, providing crucial evidence for clinicians and patients choosing between these two ketamine-based treatments.