Original Research J Clin Psychiatry July 2025

Long-Term Outcomes in Patients With Treatment-Refractory Depression Receiving Intravenous Ketamine and Intranasal Esketamine: An Observational Study

Full Article Read the complete peer-reviewed article in J Clin Psychiatry. Clinical Summary Patients with treatment-refractory depression who improve with ketamine or esketamine often need ongoing maintenance treatment, and the practical burden of how often they must return can shape adherence, cost, and quality of life. This study addresses a question clinicians face in real practice: whether intravenous ketamine or intranasal esketamine provides more durable maintenance benefit once the acute phase is over. FAQ Which treatment lasted longer between maintenance sessions in this study: intravenous ketamine or intranasal esketamine? 11 questions
Key Takeaways Symptom trajectories diverged over maintenance despite similar baseline severity: at year 1, mean QIDS-SR was 7.6 (95% CI, 5.7–9.6) with IV-KET versus 11.7 (95% CI, 9.3–14.0) with IN-ESKET (P = .01). 6 takeaways Clinical Guide How should clinicians compare maintenance intravenous ketamine and intranasal esketamine for adults with treatment-refractory depression? 6 steps Clinical Guide How did this clinic start, taper, and reassess maintenance ketamine or esketamine treatment for adults with treatment-refractory depression? 7 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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