Optimization of the Efficacy and Safety of Nalbuphine Combined with Esketamine for Post-Cesarean Analgesia: A Randomized, Double-Blind, Parallel-Controlled Clinical Study

Start Date01 Jul 2025

Sponsor / Collaborator-

NCT06853041

/ Not yet recruitingPhase 4IIT

Etude randomisée contrôlée en Double-aveugle ESKAPE : ESKétamine Low-dose Versus kétamine Low-dose Pour la Douleur Aiguë sévère Aux Urgences, Comparaison Des Effets PsychodyslEptiques

Almost 30% of painful patients in emergency departments (ED) describe their pain as severe (i.e. a Verbal Numerical Rating Score VNRS ≥ 6 on a scale ranging from 0 to 10). The management of such severe pain needs to be rapid and safe, and for this purpose intravenous (IV) morphine titration is still the gold-standard. However, morphine titration takes up considerable caregiver time, as patients need to be monitored and treated progressively with small quantities of morphine every 5 minutes until analgesia. This is sometimes difficult to reconcile with a saturating flow of patients, and overcrowding in ED is proven to significantly delay time-to-analgesia, and even lead to deleterious under-treatment. Finally, the opioid crisis is a major concern, explaining why strategies are being advocated to develop other ways of managing severe acute pain in the ED and to limit the use of opioids.
Recent studies show that ketamine administered in small IV doses ("low-dose" ketamine LDK: 0.2 to 0.3 mg/kg) possesses potent analgesic activity as well as interesting anti-hyperalgesic and anti-allodynic properties. Compared with morphine, LDK does not induce respiratory depression, but can sometimes induce disturbing psychodysleptic effects. These may include a sensation of unreality, fatigue, anxiety, dizziness or hallucinations. According to studies, 30-80% of LDK-treated patients experience psychodysleptic effects. However, two recent studies suggest that slow IV injections of LDK (over 10 minutes) may improve patient tolerance, although these slow infusions do not totally reduce this discomfort.
Pharmacologically, ketamine is a racemic mixture of 2 isomers: esketamine S(+), which is dextrorotatory, and arketamine R(-), which is levorotatory. In recent years, a new formulation containing only esketamine has been made available to hospitals in some northern European countries, and more recently in France. Esketamine appears to have twice the analgesic efficacy of racemic ketamine, and studies on healthy volunteers or in peri-operative settings suggest that it is also better tolerated psychologically than ketamine. For the moment, however, scientific data are lacking, and no comparative trial has yet been conducted in the ED setting. The investigators plan to conduct in their ED a prospective, single-center, randomized, double-blind study aiming to compare the tolerance and efficacy of esketamine versus racemic LDK in patients presenting with severe acute pain (VNRS ≥ 6/10).

Start Date01 Jun 2025

Sponsor / Collaborator

Centre Hospitalier Universitaire de Nice

NCT05603104

/ RecruitingPhase 3IIT

A Randomised, Controlled Trial to Investigate the Effect of an Intensified Pharmacological Treatment for Schizophrenia, Major Depressive Disorder and Bipolar Depression in Subjects Who Had a First-time Treatment Failure on Their First-line Treatment.

Schizophrenia, bipolar and major depressive disorders collectively affect over 10 million people across the EU and are associated with annual healthcare and societal costs in excess of 100 billion Euros. When diagnosed with one of these disorders, patients are prescribed psychotropic medication such as antidepressants, mood stabilisers or antipsychotics. It is unknown whether this first-line treatment will be successful. After this first-line treatment fails, usually a second-line treatment is initiated, and when this is not successful either a third-line treatment is initiated. Third-line treatments are quite successful, especially when compared to second-line treatments. The research question is whether the third-line treatments (early-intensified treatments) would be more efficacious than the current second-line treatments (treatment as usual) for schizophrenia, bipolar and major depressive disorders. If this is indeed the case, this could lead to the prevention of unnecessary trials of ineffective treatments and adaptations of worldwide guidelines as well as a reduction of healthcare and societal costs.

Start Date30 Apr 2025

Sponsor / Collaborator

University Medical Center of Utrecht

[+1]

100 Clinical Results associated with Esketamine Hydrochloride

100 Translational Medicine associated with Esketamine Hydrochloride

100 Patents (Medical) associated with Esketamine Hydrochloride

2,366

Literatures (Medical) associated with Esketamine Hydrochloride

31 Dec 2025·ANNALS OF MEDICINE

Respiratory depression in women receiving propofol/esketamine versus propofol/fentanyl for abortion surgery or curettage: a randomized clinical trial

Article

Author: Chen, Huihe ; Luo, Jiaxin ; Guan, Xuehai ; Wu, Xiaoshan ; Cao, Huiyu ; Lan, Hongmeng ; Lin, Yuliu ; Zhang, Cuiwen ; Liao, Yeqing ; Huang, Xiaofang

BACKGROUND:

A combination of opioids with propofol is a popular approach to non-intubated general anaesthesia; however, this method usually results in higher incidence of respiratory depression. We compared the incidence of esketamine- and fentanyl-induced respiratory depression in women undergoing abortion surgery or curettage under propofol-based non-intubated general anaesthesia.

METHODS:

This study included 176 women (aged 18-60 years) scheduled for abortion surgery or curettage. Patients were randomized into the fentanyl or esketamine groups. Patients in the fentanyl group received fentanyl (1 µg/kg) combined with propofol intravenously. Patients in the esketamine group received subanaesthetic doses of esketamine (0.15 mg/kg) combined with propofol intravenously. The primary outcome was the incidence of respiratory depression during anaesthesia. Secondary outcomes included respiratory rate, pulse oximetry, blood pressure, heart rate, propofol dose, duration of surgery, duration of anaesthesia, and adverse events.

RESULTS:

The incidence of respiratory depression in the esketamine group was significantly lower than that in the fentanyl group (11% vs. 45%; p < .0001). Propofol administration was lower with esketamine than fentanyl. Respiratory rate, SpO₂ and blood pressure were more stable in the esketamine group than in the fentanyl group. The incidences of hypotension, propofol-induced injection pain and chin lifting in the esketamine group were lower than those in the fentanyl group. The incidence of nightmares was higher in the esketamine than in the fentanyl group.

CONCLUSIONS:

The incidence of respiratory depression was lower with subanaesthetic doses of esketamine than with fentanyl in women undergoing abortion surgery or curettage under propofol-based non-intubated general anaesthesia.KEY MESSAGESOpioids combined with propofol is a popular method for non-intubated general anaesthesia; however, this method usually results in higher incidence of respiratory depression.At subanaesthetic doses, esketamine provides an analgesic effect by antagonizing the N-methyl-d-aspartate receptor.In this trial, the incidence of respiratory depression was lower with subanaesthetic doses of esketamine than with fentanyl in women undergoing abortion surgery or curettage under propofol-based non-intubated general anaesthesia.

31 Dec 2025·ANNALS OF MEDICINE

Optimal doses of intranasal esketamine plus dexmedetomidine for sedating toddlers during transthoracic echocardiography: a prospective, double-blind, randomized trial

Article

Author: Qu, Shuangquan ; Du, Zhen ; Xiao, Ting ; Zeng, Li ; Wei, Siwei ; Wang, Lei ; Pei, Dongjie

INTRODUCTION:

Esketamine has unique advantages in combination with dexmedetomidine for sedation in young children, owing to its sympathetic activity and mild respiratory depression. However, the optimal dose is yet to be determined. In this study, we compared the different doses of intranasal esketamine combined with dexmedetomidine for sedation during transthoracic echocardiography in toddlers.

PATIENTS AND METHODS:

A total of 121 eligible children aged 13 years, who were scheduled for transthoracic echocardiography were randomized into three groups. They were treated with intranasal dexmedetomidine 1 mcg.kg^-1 + esketamine 0.5 mg.kg^-1 (group S1), dexmedetomidine 1 mcg.kg^-1 + esketamine 1 mg.kg^-1 (group S2), or dexmedetomidine 1 mcg.kg^-1 + esketamine 1.5 mg.kg^-1 (group S3). The primary outcome was the success rate of sedation, other outcomes included HR, SpO₂, onset time, wake-up time, and adverse effects.

RESULTS:

The success rate of sedation was significantly higher in groups S2 (85.4%) and S3 (87.5%) than ingroup S1 (60%) (p = 0.004). The baseline HR and SpO₂ did not differ between the groups at the corresponding time points following drug administration. The onset time and duration of sedation in group S1 were significantly longer than those in groups S2 and S3 (p = 0.000). However, there were no differences in the wake-up time or adverse effects among the three groups.

CONCLUSIONS:

Intranasal administration of 1 mg.kg^-1 esketamine combined with 1 mcg.kg^-1 dexmedetomidine provided satisfactory sedation in young children undergoing transthoracic echocardiography. This sedative approach offers a rapid onset of awakening with few side effects.

CLINICAL TRIAL REGISTRATION NUMBER:

ChiCTR2200060976, 2022/06/14 (trail from August 2022 to January 2023).

01 Aug 2025·JOURNAL OF PHARMACEUTICAL AND BIOMEDICAL ANALYSIS

Chiral analysis of ketamine enantiomers in human urine and hair: Application to authentic cases of ketamine use

Article

Author: Wu, Hejian ; Zhou, Liying ; Wang, Xin ; Zhang, Zhen ; Lin, Meiting ; Xiang, Ping ; Shi, Yan

Ketamine, which possesses important anesthesia and antidepressant properties, has been used clinically in its racemate form. In the 1990s, the single enantiomer S-ketamine began to be used for clinical use. In 2019, an antidepressant S-ketamine hydrochloride nasal spray hit the market. Therefore, a method for chiral analysis of ketamine is particularly important, as this could reveal the types of drugs taken by individuals. An ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method was established for the separation of chiral ketamine in human urine and hair in this study. Urine (50 μL) was diluted in 950 μL of methanol. Approximately 20 mg of hair was extracted in methanol by cryogenic grinding. The method was applied to authentic urine, blood, and 45 hair samples. Following the deceased's use of esketamine prior to death, only S-ketamine was found in the blood and urine, suggesting that ketamine does not undergo enantiomeric inversion in vivo. The ratio of R-ketamine to S-ketamine in 45 hair samples from ketamine abusers ranged from 0.809 to 1.43, indicating that the ketamine available on the illegal drug market was predominantly in its racemate form. Furthermore, a significant difference (P = 0.039) was observed in the enantiomeric ratio of ketamine between hair samples from ketamine abusers in China and Myanmar. The enantiomeric ratios found in ketamine sourced from various origins are potentially attributable to region variations and distinct synthetic routes. These findings provide a basis for analyzing ketamine enantiomers.

353

News (Medical) associated with Esketamine Hydrochloride

31 Mar 2025

·www.globenewswire.com

Evernorth Health Services, a Cigna Company, Expands NeuroStar® TMS Coverage for Adolescents Struggling with Depression

Policy update increases access for millions covered by Evernorth Health ServicesMALVERN, Pa., March 31, 2025 (GLOBE NEWSWIRE) -- Neuronetics, Inc. (NASDAQ: STIM), a vertically integrated, commercial stage, medical technology and healthcare company with a strategic vision of transforming the lives of patients whenever and wherever they need help, with the leading neurohealth therapies in the world, announced that Evernorth Health Services, a wholly owned subsidiary of The Cigna Group, has expanded its coverage of NeuroStar® Transcranial Magnetic Stimulation (TMS) to include adolescents aged 15 and older living with major depressive disorder (MDD). As these health policies cover 15 million lives, the expansion greatly improves access to non-drug treatment options for adolescent patients who are seeking non-drug options for depression. The expansion is effective immediately, nearly one year after NeuroStar® Advanced Therapy received FDA clearance as the first first-line add-on treatment for adolescents aged 15-21 with MDD. In the past year, several leading insurers have rapidly updated their policies to reflect the FDA clearance, including but not limited to Humana, Aetna, Medi-Cal, BCBS-HCSC, Pacific Source, and more. “This decision by Cigna/Evernorth is a significant step forward for adolescent mental healthcare and reflects the momentum we have built with payors over the past year since NeuroStar first received the FDA clearance for adolescents,” said Keith J. Sullivan, President and CEO of Neuronetics. “We are grateful that millions more families will now have easier access to NeuroStar TMS as a proven, non-drug treatment for major depression and can get the care they deserve.” An estimated 4.3 million U.S. adolescents aged 15-21 are affected by major depression1. Depression amongst adolescents can disrupt crucial aspects of development, such as academic performance, relationships with peers and family members, and overall emotional well-being. With limited medication options for adolescents with MDD, NeuroStar is a safe and effective option that can be used as a first-line add-on with robust clinical outcomes. “NeuroStar stands as the leading TMS device, backed by the most comprehensive data that clearly demonstrates its effectiveness in treating adolescent major depressive disorder,” said Geoffrey Grammer, MD, Chief Medical Officer of Neuronetics. “At Neuronetics, we are deeply committed to putting patients first, advancing clinical research, and ensuring that those in need have access to life-changing, innovative solutions.” Neuronetics is the only TMS company in the industry with a dedicated health policy team that partners with both providers and payors to advocate for health policy updates. For more information about NeuroStar Advanced Therapy, please visit www.neurostar.com. About Neuronetics Neuronetics, Inc. believes that mental health is as important as physical health. As a global leader in neuroscience, Neuronetics is delivering more treatment options to patients and physicians by offering exceptional in-office treatments that produce extraordinary results. NeuroStar Advanced Therapy is a non-drug, noninvasive treatment that can improve the quality of life for people suffering from neurohealth conditions when traditional medication has not helped. In addition to selling the NeuroStar Advanced Therapy System and associated treatment sessions to customers, Neuronetics operates Greenbrook TMS Inc. (Greenbrook) treatment centers across the United States, offering NeuroStar Advanced Therapy for the treatment of MDD and other mental health disorders. NeuroStar Advanced Therapy is the leading TMS treatment for MDD in adults, with more than 7.1 million treatments delivered, and is backed by the largest clinical data set of any TMS treatment system for depression, including the world’s largest depression outcomes database. Greenbrook treatment centers also offer SPRAVATO® (esketamine) Nasal Spray, a prescription medicine indicated for the treatment of treatment-resistant depression (TRD) in adults as monotherapy or in conjunction with an oral antidepressant. It is also indicated for depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior in conjunction with an oral antidepressant.1 Greenbrook has provided more than 1.68 million treatments to over 51,000 patients struggling with depression. The NeuroStar Advanced Therapy System is cleared by the U.S. Food and Drug Administration for adults with MDD, as an adjunct for adults with obsessive-compulsive disorder, to decrease anxiety symptoms in adult patients with MDD that may exhibit comorbid anxiety symptoms (anxious depression), and as a first line adjunct for the treatment of MDD in adolescent patients aged 15-21. For safety information and indications for use, visit NeuroStar.com. Neuronetics Contact:Investors:Mike Vallie or Mark KlausnerICR Healthcare443-213-0499ir@neuronetics.com Media:EvolveMKD646.517.4220NeuroStar@evolvemkd.com References World Health Organization, Depression Fact Sheet. Accessed April 29, 2024. https://www.who.int/news-room/fact-sheets/detail/depression. ________________________________* The effectiveness of SPRAVATO® in preventing suicide or in reducing suicidal ideation or behavior has not been demonstrated. Use of SPRAVATO® does not preclude the need for hospitalization if clinically warranted, even if patients experience improvement after an initial dose of SPRAVATO®. For more important safety information about SPRAVATO®, please visit spravatohcp.com.

Drug Approval

26 Mar 2025

·endpts.com

FDA approves first drug for Prader-Willi syndrome, to tamp down insatiable hunger symptoms

The FDA on Wednesday approved Soleno Therapeutics’ new drug designed to treat the worst symptom of a debilitating rare disease known as Prader-Willi syndrome. Regulators approved diazoxide choline (often shortened to DCCR) to treat insatiable hunger, or hyperphagia, felt by patients with Prader-Willi syndrome, a rare disease caused by spontaneous genetic mutations. The drug will be branded as Vykat XR and will cost an average of $466,200 per year, Soleno executives said late Wednesday. Soleno expects the drug to be available as soon as next month, according to an SEC document . Patients with Prader-Willi syndrome are typically diagnosed at birth because they are born “floppy,” with little muscle tone, CEO Anish Bhatnagar told Endpoints News ahead of the FDA’s decision. But their hyperphagia symptoms typically manifest when a patient is between 8 and 12 years old. Some may exhibit hyperphagia as early as four years. “When these babies are born, they are born with very low muscle tone, and so they’re called floppy babies,” Bhatnagar said. “You pick up the baby in the palm of your hand, and they would drape over on both sides. So it’s very obvious to the doctor at the time that something is wrong.” The disease is caused by random mutations of chromosome 15 and occurs in roughly one of every 15,000 live births globally. It’s not an inherited disease, so the prevalence is consistent across different geographies and ethnicities. In Western countries, “virtually all” of these babies end up in the NICU, Bhatnagar said. There are no other approved treatments for patients with Prader-Willi syndrome. Patients with Prader-Willi syndrome have a wide range of symptoms beyond hyperphagia, including delayed motor skills, not making enough growth hormone and speech and behavioral problems. But hyperphagia remains the most difficult for patients and their families. Divorce rates among parents of children with Prader-Willi syndrome are higher than normal, and unaffected siblings sometimes have PTSD from patients’ sometimes aggressive food-seeking behaviors. Families have to lock access to all food and trash cans in the house, Bhatnagar said. Patients may end up living in group homes for those with Prader-Willi syndrome if their families can afford it. Other times, they know their hyperphagia is a problem but can’t do anything about it. The behavioral problems often lead to mental health challenges and prescriptions for antidepressants, but those don’t tend to help. “As rare diseases go, this is one of those problems which is truly intractable,” the CEO said. Vykat XR doesn’t treat the underlying genetic cause of the disease. But by going after the intense desire to eat, Soleno hopes patients and families can alleviate the condition’s biggest burden. It works by targeting KATP, or the ATP-dependent potassium channel, and a hunger mechanism in the hypothalamus to reduce appetite. Vykat XR is a once-daily pill. Soleno intends to commercialize Vykat XR on its own in the US, though it may seek a partner to commercialize the drug elsewhere, Bhatnagar said. Soleno had $318 million in cash and cash equivalents at the end of 2024, and Bhatnagar said the company is “well-positioned” to launch Vykat XR. Some analysts think the drug could become a blockbuster. Stifel’s Paul Matteis wrote earlier this month that Vykat XR could reach at least $1.5 billion in annual peak sales despite the drug failing its primary endpoint in Phase 3 due to a pandemic-related high placebo response. But the FDA has opted to exercise more flexibility in rare disease approvals, Matteis added, and a randomized withdrawal study after the Phase 3 was highly statistically significant. Johnson & Johnson’s Spravato — a depression treatment — was approved in January using a similar trial framework. “We believe there’s potential upside here, as well,” Matteis wrote. Editor’s note: This article has been updated with Vykat XR’s average annual price.

Drug ApprovalPhase 3Clinical Result

21 Mar 2025

·www.pharmaceutical-technology.com

FDA approves Johnson & Johnson’s Tremfya to treat Crohn’s disease

Johnson & Johnson developed the dual-acting monoclonal antibody. Credit: Skorzewiak/Shutterstock. Johnson & Johnson (J&J) has received US Food and Drug Administration (FDA) approval for its interleukin 23 inhibitor, Tremfya (guselkumab), to treat moderately to severely active Crohn’s disease (CD) in adults. The approval introduces the therapy with both subcutaneous (SC) and intravenous (IV) induction alternatives for this gastrointestinal tract’s chronic inflammatory condition. The fully human dual-acting monoclonal antibody attaches to the cluster of differentiation 64, targeting inflammation at its cellular source. This milestone follows the drug’s previous approval from the agency for ulcerative colitis, another form of inflammatory bowel disease. The latest decision is based on the outcomes from several Phase III trials, which comprised more than 1,300 CD subjects who were not tolerant to conventional treatments or biologics. The GRAVITI trial evaluated SC induction of the antibody and maintenance therapy against a placebo. GALAXI clinical programme data revealed that the antibody was superior to Stelara across all pooled endoscopic endpoints. The comprehensive findings from these Phase III trials showcased the efficacy of both SC and IV formulations of the antibody in meeting endoscopic and clinical endpoints. J&J innovative medicine gastroenterology and autoantibody medical affairs vice-president Chris Gasink stated: “With the approval of Tremfya, it is now possible to achieve meaningful improvements in clinical and endoscopic outcomes with the flexibility of self-administration from the start. “Tremfya provides people living with CD and their healthcare providers a new treatment option that is supported by data from multiple Phase III studies, including pooled analyses showing statistical superiority versus Stelara across four endoscopic or combined clinical and endoscopic endpoints.” Tremfya’s latest approval marks its fourth indication in the country. In November 2024, the company submitted a supplemental biologics licence application to the US regulator for an SC induction regimen of the antibody for UC. In January, 2025, J&J’s nasal spray Spravato secured a label expansion from the FDA for use as a single agent in adults with major depressive disorder (who were not responsive to two oral antidepressants.

Phase 3Drug ApprovalClinical ResultBiosimilar

100 Deals associated with Esketamine Hydrochloride

External Link

KEGG	Wiki	ATC	Drug Bank
D10627	Esketamine Hydrochloride	N01AX14 N06AX27	DB11823

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Approved

10 top approved records.

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Indication	Country/Location	Organization	Date
Depressive Disorder	China	Janssen-Cilag International NV	17 Apr 2023
Major depressive disorder, moderate (MDD)	Australia	Janssen-Cilag Pty Ltd.	09 Mar 2021
Depressive Disorder, Major	European Union	Janssen-Cilag International NV	18 Dec 2019
Depressive Disorder, Major	Iceland	Janssen-Cilag International NV	18 Dec 2019
Depressive Disorder, Major	Liechtenstein	Janssen-Cilag International NV	18 Dec 2019
Depressive Disorder, Major	Norway	Janssen-Cilag International NV	18 Dec 2019
Anesthesia	China	Jiangsu Hengrui Pharmaceuticals Co., Ltd.	18 Nov 2019
Depressive Disorder, Treatment-Resistant	United States	Janssen Pharmaceuticals, Inc.	05 Mar 2019
Pain	Germany	Pfizer Inc.	01 Aug 1997

Developing

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Suicidal Ideation	Phase 3	United States	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	Bulgaria	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	Estonia	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	Germany	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	Hungary	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	Malaysia	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	Slovakia	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	South Africa	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	Spain	Janssen Research & Development LLC	09 Jun 2017
Suicidal Ideation	Phase 3	Taiwan Province	Janssen Research & Development LLC	09 Jun 2017

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT05464979 (Pubmed \| Sci Rep)	Phase 4	-	80	Esketamine	ctxpwzotfq(xtnaugyamm) = slexwxryqi ujmaunwnbh (artnxrpyuw, 4.0 - 16.3)	Positive	19 Feb 2025
				Midazolam/sufentanil admixture	ctxpwzotfq(xtnaugyamm) = kukasaouqb ujmaunwnbh (artnxrpyuw, 8.0 - 26.0)
ChiCTR2400087873 (Pubmed \| BMC Anesthesiol)	Not Applicable	-	90	Intranasal Dexmedetomidine	nwelxlpspf(ouqegthyit) = bradycardia, hypotension, hypoxia, emergence delirium etc. lpgbvlqsuu (qrwigfqgvf )	Positive	11 Feb 2025
				Intranasal Dexmedetomidine-Esketamine
ChiCTR2300069632 (Pubmed) Manual	Not Applicable	Pain	135	esketamine	gzwjeituxm(expsjvtime): P-Value = P<0.05 View more	Positive	20 Jan 2025
				sufentanil
NCT04599855 (FDA_CDER) Manual	Phase 4	Depressive Disorder, Treatment-Resistant	-	SPRAVATO (56 mg)	rqbqljghak(sbruvndotx) = ynzzgtlumy guweybqbbi (slezprmnwm, 1.2)	Positive	17 Jan 2025
				SPRAVATO (84 mg)	rqbqljghak(sbruvndotx) = eghllafaor guweybqbbi (slezprmnwm, 1.2)
NCT03097133 \| NCT03039192 (FDA_CDER) Manual	Phase 3	Depressive Disorder, Major	-	SPRAVATO 84 mg +SOC (NCT03039192)	iicwpfocwn(mzjsgqhtro) = fvcxybqyjf yphybmlmho (gnqxduioxp, 1.04)	Positive	17 Jan 2025
				Placebo nasal spray + SOC (NCT03039192)	iicwpfocwn(mzjsgqhtro) = nnqtfdymog yphybmlmho (gnqxduioxp, 1.02)
NCT06398834 (Pubmed \| Int J Clin Pharm)	Phase 4	-	181	Esketamine + Butorphanol	kqeyrjoeky(xafqjbxaiu) = qsxdczaqbo vhnklsotav (fjqfvlrofg )	Positive	03 Jan 2025
				Butorphanol	kqeyrjoeky(xafqjbxaiu) = qfpqpfihat vhnklsotav (fjqfvlrofg )
NCT03373253 \| NCT02497287 (ICEBERG, Pubmed \| Front Psychiatry)	Phase 3	Functional disorder	696	Esketamine nasal spray + SSRI/SNRI	rppgtqhprr(pqhvmfoaby) = lwajrbryoj ybylftxihp (qzcaymdfcp, 21.8 - 29.4)	Positive	07 Oct 2024
				esketamine nasal spray (Real-world treatment (RWT))	rppgtqhprr(pqhvmfoaby) = jrgrlbyxqc ybylftxihp (qzcaymdfcp, 6.9 - 16.1)
ChiCTR2200061956 (not available, Pubmed \| BMC Anesthesiol)	Phase 4	Hip Fractures brain-derived neurotrophic factor (BDNF) \| 5-hydroxytryptamine (5-HT)	90	Esketamine	rvnyzpdjzp(phbpvbahzw) = sqeuepfkql yubvwzxkoe (gzpjlmysep ) View more	Positive	28 Sep 2024
				Saline	rvnyzpdjzp(phbpvbahzw) = neguiuyydh yubvwzxkoe (gzpjlmysep ) View more
NCT04757675 (Pubmed \| Transl Pediatr)	Early Phase 1	Strabismus	-	Intranasal esketamine 2 mg/kg	ymyndjmyfr(rewhgylqov) = More gastrointestinal events were observed in Group K (P<0.001) jmjdaslziq (fkeeguubhf )	Negative	01 Aug 2024
				Intranasal esketamine 1 mg/kg and dexmedetomidine 1 µg/kg
ChiCTR2100054199 (Pubmed \| JAMA Netw Open)	Early Phase 1	Depression, Postpartum	298	Esketamine	cqgedhdarc(ssutvzktvd) = povnenaawp zilzvcocdt (sybkbamygy )	Positive	06 Mar 2024
				Control (Saline)	cqgedhdarc(ssutvzktvd) = funfvpcynf zilzvcocdt (sybkbamygy )

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