Esketamine (Nasal Spray)
Treatment for Depression
Typical Dosage: 56mg or 84mg (induction), then weekly/bi-weekly
Effectiveness
72%
Safety Score
45%
Clinical Trials
20
Participants
10K
Comparative Safety Scale(Higher is safer)
Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
45
DangerousModerateSafe
Treatment Details
Dosage Range
56mg or 84mg (induction), then weekly/bi-weekly
Time to Effect
Hours to days
Treatment Duration
Induction: 4 weeks (2x/week); Maintenance: weekly/bi-weekly, long-term
Evidence Quality
MODERATENumber Needed to Treat (NNT)
6(Treat 6 patients to see 1 additional successful outcome)
Confidence Score
80%confidence in effectiveness data
Health Economics
Annual Cost of Care
Drug Cost:$40,000
Monitoring:$500
Side Effect Mgmt:$300
Total Annual:$40,800
Cost-Effectiveness Analysis
Cost-Effectiveness Rating
POORICER
$350,000/QALY
QALYs Gained
0.4
Outcome-Based Costs
Cost per Responder
$81,600
Cost per Remission
$116,571
Esketamine (Nasal Spray) Outcomes
for Depression
Efficacy Outcomes
Overall Effectiveness
+72%
Response Rate
+50%
Remission Rate
+35%
Common Side Effects
Dissociation
+40%
Nausea/Vomiting
+25%
Vertigo
+25%
Sedation
+30%
Hypertension
+15%
Sources:
Active Clinical Trials
8 active trials recruiting for Esketamine (Nasal Spray) in Depression
Positioning of Esketamine Treatment in the Real-world Management of Depression
NCT06103760RECRUITINGPHASE4
162 participants
INTERVENTIONAL
St Leonards, Australia
Started: Oct 31, 2023
A Study of Esketamine Nasal Spray in Korean Participants With Treatment-resistant Depression
NCT07053345RECRUITINGPHASE4
47 participants
INTERVENTIONAL
Goyang Si Gyeonggi Do, South Korea +5 more
Started: Jun 9, 2025
Esketamine Nasal Spray in Real-World Settings in Treatment-Resistant Depression
NCT07146503RECRUITING
100 participants
OBSERVATIONAL
Genova, Italy +3 more
Started: Nov 1, 2022
Retrospective Analyses of the Greenbrook Database Evaluating Mental Health Treatments
NCT06997549RECRUITING
12K participants
OBSERVATIONAL
Malvern, United States
Started: May 15, 2025
Comparison of Esketamine Nasal Spray vs.Aripiprazole in Treat.Resistant Major Depressive Disorder in Elderly Patients
NCT07153406NOT YET RECRUITINGPHASE3
220 participants
INTERVENTIONAL
Pamplona, Spain +8 more
Started: Sep 15, 2025
The Effect of a Six Week Intensified Pharmacological Treatment for Major Depressive Disorder Compared to Treatment as Usual in Subjects Who Had a First-time Treatment Failure on Their First-line Treatment.
NCT05973851RECRUITINGPHASE3
418 participants
INTERVENTIONAL
Innsbruck, Austria +11 more
Started: Aug 31, 2024
IV Ketamine Vs. in Esketamine for MDD TRD
NCT06488586RECRUITING
80 participants
OBSERVATIONAL
Kingston, Canada
Started: Mar 20, 2023
Intensified Pharmacological Treatment for Schizophrenia, Major Depressive Disorder and Bipolar Depression After a First-time Treatment Failure
NCT05603104RECRUITINGPHASE3
1.25K participants
INTERVENTIONAL
Ramat Gan, Israel
Started: Apr 27, 2025
Completed Clinical Trials
7 completed trials for Esketamine (Nasal Spray) in Depression
Brain Network Dynamics of Depression During Esketamine Treatment
NCT06012916COMPLETED
8 participants
OBSERVATIONAL
Chapel Hill, United States
Started: Jul 3, 2023
A Long-term Safety Study of Esketamine Nasal Spray in Treatment-resistant Depression
NCT02782104COMPLETEDPHASE3
1.15K participants
INTERVENTIONAL
Birmingham, United States +172 more
Started: Jun 9, 2016
(GluEsk) Glutamate and Esketamine
NCT06432322COMPLETEDNA
16 participants
INTERVENTIONAL
Oxford, United Kingdom
Started: Jun 14, 2024
A Study of Esketamine Nasal Spray, Administered as Monotherapy, in Adult Participants With Treatment-resistant Depression
NCT04599855COMPLETEDPHASE4
477 participants
INTERVENTIONAL
Birmingham, United States +53 more
Started: Nov 4, 2020
A Double-blind Study to Assess the Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Participants Who Are Assessed to be at Imminent Risk for Suicide
NCT02133001COMPLETEDPHASE2
68 participants
INTERVENTIONAL
Birmingham, United States +13 more
Started: May 23, 2014
A Long-Term Extension Study for Participants With Treatment-resistant Major Depressive Disorder Who Are Continuing Esketamine Nasal Spray Treatment
NCT04829318COMPLETEDPHASE4
183 participants
INTERVENTIONAL
Buenos Aires, Argentina +58 more
Started: Apr 26, 2021
A Long-term Comparison of Esketamine Nasal Spray Versus Quetiapine Extended Release, Both in Combination With a Selective Serotonin Reuptake Inhibitor/Serotonin-Norepinephrine Reuptake Inhibitor, in Participants With Treatment Resistant Major Depressive Disorder
NCT04338321COMPLETEDPHASE3
676 participants
INTERVENTIONAL
Buenos Aires, Argentina +170 more
Started: Aug 21, 2020