Relative Efficacy Ketamine : Does the Formulation and Delivery Matter with Respect to Efficacy, Tolerability and Safety?

In March of 2019, the US FDA approved intranasal esketamine for treatment-resistant depression (TRD). Conceptually, this is an extraordinary event from the point of view of drug development in psychiatry insofar as this is the first time the FDA has approved an antidepressant medicine that was developed on the basis of an a priori diseases model (i.e. glutamatergic dysregulation relevant to the pathogenesis of mood disorders).