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Ketamine for Treatment Resistant Depression: Real World Evidence

Treatment-resistant depression affects up to one third of patients with major depressive disorder and is linked to severe impairment and suicide risk. Real-world clinical data show that ketamine offers rapid antidepressant effects, with meaningful symptom reduction in nearly half of treated patients and remission in around one third. Benefits often appear within hours or days and can be maintained over time with follow-up treatment. Evidence also indicates good tolerability, low risk of symptom worsening and effectiveness in both unipolar and bipolar depression.

Administration methods

This article explains the key differences and similarities between ketamine and esketamine in the treatment of resistant depression. It reviews their shared glutamatergic mechanisms, distinct stereoisomeric forms, routes of administration and side effect profiles. Evidence from preclinical and clinical studies suggests racemic ketamine and R-ketamine may offer longer lasting antidepressant effects and fewer adverse reactions than S-ketamine. The text also addresses subjective experiences, dissociative effects, cost, regulatory issues and why many clinics prioritize racemic ketamine in personalized, evidence based care.

Group therapy in Barcelona

Discover group therapy at our clinic in Barcelona. A safe space to share, grow, and improve your emotional well-being with professional support.

Fear, trauma and MDMA

We talk about fear and trauma, discussing the possible use of MDMA for the treatment of PTSD

Discovering your nervous system – psychoeducation course

At Clínica Synaptica we consider psychoeducation to be an important tool that can be of great benefit in the therapeutic process. Psychoeducation is a way of accompanying and sharing knowledge about mental health issues that promotes self-knowledge.

Interview with Phil Wolfson

Phil Wolfson, the creator of ketamine-assisted psychotherapy, answers some questions about the current landscape in the field

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