# Ketamine and esketamine in the treatment of treatment-resistant depression: mechanisms of action, clinical efficacy, and safety - URL: https://alisanburak.com/en/wcp-2026-posterler/ev1148 - Language: en - Last updated: not specified - Page title: Ketamine and esketamine in the treatment of treatment-resistant depression: mechanisms of action, clinical efficacy, and safety | WCP 2026 Summary > Ketamine and esketamine offer a rapid and effective treatment option for treatment-resistant depression, but uncertainties remain regarding long-term safety an… This page was translated automatically from Turkish. [Read the original](https://alisanburak.com/wcp-2026-posterler/ev1148) This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it. EV1148 E-PosterPsychopharmacologyReview # Ketamine and esketamine in the treatment of treatment-resistant depression: mechanisms of action, clinical efficacy, and safety KETAMINE AND ESKETAMINE IN THE TREATMENT OF TREATMENT-RESISTANT DEPRESSION: MECHANISMS OF ACTION, CLINICAL EFFICACY, AND SAFETY Presenter: Maria-Angeliki Panagopoulou Country: Greece Ketamine and esketamine offer a rapid and effective treatment option for treatment-resistant depression, but uncertainties remain regarding long-term safety and optimal dosing. This review aimed to examine the efficacy and safety of ketamine and esketamine in major depressive disorder (MDD); it noted that approximately 30% of patients develop treatment-resistant depression (TRD) despite available pharmacotherapies (SSRIs, SNRIs). The methodology involved searching the PubMed database for clinical trials, systematic reviews, meta-analyses, and observational studies involving patients with MDD. Ketamine was described as a racemic mixture of the (R) and (S) enantiomers, whereas esketamine is the pure (S) enantiomer; through N-methyl-D-aspartate (NMDA) receptor antagonism, these agents enhance AMPA receptor-mediated glutamatergic transmission, promoting neuroplasticity primarily in the medial prefrontal cortex and restoring synaptic function. It was also noted that they may reduce anhedonia by modulating the dopaminergic reward system. Clinically, unlike conventional antidepressants, which take weeks to exert their effects, these agents rapidly reduce depressive symptoms and suicidal ideation within hours; effects may persist for up to one week after a single intravenous dose, and repeated administration may prolong and stabilize the response. The most common adverse effects are transient, mild, and self-limiting, and are primarily attributable to sympathetic nervous system activation; inhibition of vagal activity and blockade of norepinephrine reuptake in peripheral nerves and the myocardium lead to tachycardia, fluctuations in systemic and pulmonary arterial pressure, and increases in cardiac output and myocardial oxygen consumption. Clinical manifestations include depersonalization, psychotomimetic effects, nausea, dizziness, and acute hemodynamic changes; transient hypertension, depersonalization, psychotomimetic effects, lightheadedness, and vertigo are prominent with standard ketamine (IV/IM), whereas lightheadedness, vertigo, blurred vision, nasal discomfort, and sedation are prominent with intranasal esketamine. In conclusion, both agents offer a rapid and effective option for patients with TRD, but further research is needed to assess long-term safety, optimal dosing, and specific subgroups. [View the original poster](https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/335) How to cite this study APA 7: Panagopoulou, M-A., et al. (2026, September 23-26). Ketamine and esketamine in the treatment of treatment-resistant depression: mechanisms of action, clinical efficacy, and safety [E-poster]. 26th WPA World Congress of Psychiatry (WCP 2026), Stockholm, Sweden. https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/335 Vancouver: Panagopoulou MA, et al. Ketamine and esketamine in the treatment of treatment-resistant depression: mechanisms of action, clinical efficacy, and safety [e-poster]. 26th WPA World Congress of Psychiatry (WCP 2026); 2026 Sep 23-26; Stockholm, Sweden. Available from: https://cslide.ctimeetingtech.com/wcp26/attendee/eposter/file/335 Author names and title formatting were generated automatically from the congress system; please check them against the original poster before use. ## On the same topic - [Açığı kapatmak: erişkin DEHB ilacı başlanmadan önce EKG sevk uyumunun iyileştirilmesi, kapalı döngü klinik denetim](https://alisanburak.com/en/wcp-2026-posterler/ev0088) - [Anksiyete bozukluğu olan hastalarda psikobiyotik müdahalesi: ısıl işlem görmüş Lactobacillus paracasei PS23'ün etkilerini inceleyen çift kör randomize kontrollü çalışma](https://alisanburak.com/en/wcp-2026-posterler/ev0126) - [Otizm spektrum bozukluğunda bumetanidin tedavi edici potansiyeli: güncel kanıtlar ve gelecek yönelimleri](https://alisanburak.com/en/wcp-2026-posterler/ev0157) - [Verbaskozid ile otizm spektrum bozukluğu tedavisinin mekanizmaları: ağ farmakolojisi, moleküler yerleştirme ve moleküler dinamik temelli inceleme](https://alisanburak.com/en/wcp-2026-posterler/ev0172) - [Otizm spektrum bozukluğunun çekirdek belirtilerinin tedavisinde kannabidiol: sistematik derleme](https://alisanburak.com/en/wcp-2026-posterler/ev0186) [All WCP 2026 summaries](https://alisanburak.com/en/wcp-2026-posterler) --- Kaynak / Source: https://alisanburak.com/en/wcp-2026-posterler/ev1148 İletişim / Contact: Bağdat Caddesi, Veli Güneysu Apt. No:453 K:4 D:9, Suadiye / Kadıköy, İstanbul · +90 532 642 95 25 · info@alisanburak.com · https://alisanburak.com/bagdat-caddesi-psikoterapi-iletisim