Esketamine in TRD: The Evidence Base and the Cost Critique

In ‘Esketamine in TRD: The Evidence Base and the Cost Critique,’ our expert delves into the following critical questions:

Where is the evidence base for esketamine in treatment-resistant depression strongest, and which studies matter most?

How should clinicians respond to the critique that racemic ketamine is cheaper and comparably effective, and that esketamine’s benefit over placebo in treatment-resistant depression trials has been modest?

Led by the moderator, the expert psychiatrist discusses the TRANSFORM and SUSTAIN trials as the strongest evidence for esketamine and notes that the requirement for a concomitant oral antidepressant has since been lifted. He argues that ketamine’s low drug cost does not reflect the full cost of delivering care safely, and that the difference between esketamine and placebo is meaningful for each patient who benefits.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

Our next episode, ‘Choosing Between Ketamine and Esketamine in TRD,’ further explores treatment-resistant depression, highlighting which patients he steers toward each agent and how the 2 compare on safety and efficacy.