Original Research J Clin Psychiatry May 2026

Cognitive Behavioral Therapy Following Esketamine for Major Depression and Suicidal Ideation for Relapse Prevention: The CBT-ENDURE Randomized Trial

Full Article Read the complete peer-reviewed article in J Clin Psychiatry. Clinical Summary Patients hospitalized or recently discharged with major depression and suicidal ideation remain at high relapse and suicide risk after the standard 4-week esketamine course ends. This trial asks the practical next-step question: whether adding a structured 16-week CBT course can sustain gains and improve longer-term outcomes in a population that most psychiatric trials have historically excluded. FAQ Did adding CBT to esketamine improve outcomes in major depression with suicidal ideation? 10 questions
Key Takeaways The cohort was highly ill and clinically relevant to inpatient psychiatry: 61.9% were enrolled while hospitalized, 45% had a lifetime suicide attempt, the mean MADRS was 39.0 (SD, 7.7), and the mean number of previous antidepressant failures was 3.9 (SD, 3.0). 6 takeaways · 4 clinical pearls Clinical Guide How should clinicians structure adjunctive CBT after an acute esketamine course for patients with major depression and suicidal ideation? 8 steps Clinical Guide Which measures should clinicians use to follow suicidal ideation and related worsening after esketamine with or without CBT in major depression? 6 steps
Physicians Postgraduate Press, Inc. (PPP) makes no warranties about the accuracy or completeness of any information published in The Journal of Clinical Psychiatry or other PPP materials, and disclaims liability for any use or non-use of that information. Clinicians should not rely solely on these materials and should exercise their own professional judgment when making patient care decisions on an individualized basis.

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