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Research/Esketamine for Depressive Disorders/Dose summaries
Curated dose summary

Esketamine for Depressive Disorders: dose summaries

Esketamine clinical studies for Depressive Disorders include 24 structured dose rows across 20 linked trials. Common source-reported dose patterns include 84 mg, 0.2 mg/kg, 56 mg. Interpret these as descriptive trial protocols, not treatment recommendations.

Clinical studies
20
Dose rows
24
Source papers
32
Needs review
1

How to read this summary

This page summarizes source-structured dosing used in linked human clinical studies. It preserves the source-reported unit, route, frequency, and regimen notes where available.

Source-reported protocol patterns

Patterns group structured dose rows with the same reported dose, route, and regimen type. They preserve source units and do not imply clinical equivalence.

3 rows

84 mg via Other (multi-dose)

Reported in 3 dose rows. Source rows retain their original units and should be read descriptively, not as dosing guidance.

Routes: Other

2 rows

0.2 mg/kg via IV (fixed)

Reported in 2 dose rows. Source rows retain their original units and should be read descriptively, not as dosing guidance.

Routes: IV

2 rows

56 mg via Other

Reported in 2 dose rows. Source rows retain their original units and should be read descriptively, not as dosing guidance.

Routes: Other

2 rows

84 mg via Other

Reported in 2 dose rows. Source rows retain their original units and should be read descriptively, not as dosing guidance.

Routes: Other

1 row

0.25 mg/kg via IV (multi-dose)

Reported in 1 dose row. Source rows retain their original units and should be read descriptively, not as dosing guidance.

Routes: IV

1 row

0.25 mg/kg via IV (fixed)

Reported in 1 dose row. Source rows retain their original units and should be read descriptively, not as dosing guidance.

Routes: IV

1 row

0.5 mg/kg via Intranasal (multi-dose)

Reported in 1 dose row. Source rows retain their original units and should be read descriptively, not as dosing guidance.

Routes: Intranasal

1 row

0.5 mg/kg via Oral (titrated)

Reported in 1 dose row. Source rows retain their original units and should be read descriptively, not as dosing guidance.

Routes: Oral

Traceable dose rows

Each row comes from a linked clinical trial intervention. Rows with missing or reviewed-incomplete dosing stay visible instead of being filled by inference.

Back to evidence set →
StudyArmDoseRoute and regimenSource status
A Long-term Comparison of Esketamine Nasal Spray Versus Quetiapine Extended Release, Both in Combination With a Selective Serotonin Reuptake Inhibitor/​Serotonin-Norepinephrine Reuptake Inhibitor, in Participants With Treatment Resistant Major Depressive Disorder (ESCAPE-TRD)
TrialPaperNCT04338321
Esketamine
Esketamine
56-84 mg
Other | flexible
twice-weekly (Day1–Week4), then weekly (Week5–8), then weekly or every 2 weeks (Week9–32)

Nasal spray; doses 28, 56, or 84 mg; 28 mg initial option for elderly/Japanese ancestry; flexible uptitration per protocol.

Not reviewed
existing-data | esketamine-nasal-spray-versus-quetiapine-for-treatment-resistant-depression
A Long-Term Extension Study for Participants With Treatment-resistant Major Depressive Disorder Who Are Continuing Esketamine Nasal Spray Treatment
TrialPaperNCT04829318
Esketamine
Esketamine
Not reported
Other
weekly or every 2 weeks

Self-administered intranasal esketamine per prior study dosing and investigator judgment; dosing adjusted per local SmPC.

Not reviewed
long-term-treatment-with-esketamine-nasal-spray-in-patients-with-treatment-resistant-depression
A Long-term Safety Study of Esketamine Nasal Spray in Treatment-resistant Depression (SUSTAIN-3)
TrialPaperNCT02782104
Esketamine Nasal Spray
Esketamine
28-84 mg
Inhalation | flexible
twice per week (induction) then weekly or every other week (maintenance)

Flexible dosing: 28, 56 or 84 mg depending on age and prior study dosing; participants <65 typically 56 or 84 mg, ≥65 start at 28 mg. Induction = twice weekly for 4 weeks (≈8 sessions); maintenance individualised after Week 4. Dose data found during issue #220 source review.

Source Backed
registry | registry:NCT02782104

Depression (SUSTAIN-3) NCT02782104 https://clinicaltrials.gov/study/NCT02782104 Open-label, long-term extension Phase III safety study (n≈1148) of esketamine nasal spray (flexible 28–84 mg dosing) in participants with treatment-resistant depression, induction twice weekly for 4 weeks then individualised maintenance. This open-label extension evaluates the long-term

A Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression (SUSTAIN-2)
TrialPaperNCT02497287
Esketamine + antidepressant
Esketamine
56-84 mg
Intranasal
twice weekly (induction); then weekly or every other week (maintenance)

Flexible dosing: <65 yrs 56 or 84 mg; ≥65 yrs start 28 mg (28, 56 or 84 mg possible).

Not reviewed
existing-data | adverse-events-and-measurement-of-dissociation-after-the-first-dose-of-esketamin
A randomised controlled trial of oral S-ketamine as add-on medication for patients with treatment-resistant major depressive disorder
TrialPaperNL6030
S-ketamine
Esketamine
Needs review
Oral | multi-dose
three times daily

Oral S‑ketamine TID for 6 weeks with tapered start and finish; exact mg not specified in registry. paper:oral-esketamine-in-patients-with-treatment-resistant-depression-a-double-blind-r: Multiple candidate dose values found near Esketamine (30 mg, 0.5-3 mg/kg); manual mapping needed. | Supplement is not parsed as PDF: paper:oral-esket...

Needs Review
needs-review | oral-esketamine-in-patients-with-treatment-resistant-depression-a-double-blind-r
A Study of Esketamine Nasal Spray, Administered as Monotherapy, in Adult Participants With Treatment-resistant Depression
TrialPaperNCT04599855
Esketamine 56 mg
Esketamine
56 mg
Other
twice a week | 8 doses

Intranasal self-administration; JNJ-54135419

Not reviewed
existing-data | esketamine-monotherapy-in-adults-with-treatment-resistant-depression-a-randomize
A Study of Esketamine Nasal Spray, Administered as Monotherapy, in Adult Participants With Treatment-resistant Depression
TrialPaperNCT04599855
Esketamine 84 mg
Esketamine
84 mg
Other
twice a week | 8 doses

Intranasal self-administration; JNJ-54135419

Not reviewed
existing-data | esketamine-monotherapy-in-adults-with-treatment-resistant-depression-a-randomize
A Study to Evaluate the Efficacy and Safety of Esketamine Combined With Oral Antidepressants in the Treatment of Major Depressive Disorder With Suicidal Ideation
TrialPaperChiCTR2000041232
Intravenous esketamine
Esketamine
0.25 mg/kg
IV | multi-dose
3 infusions over 5 days (days 1, 3, and 5) | 3 doses

Infused in 50 mL of 0.9% saline over 40 minutes.

Not reviewed
existing-data | short-term-cognitive-effects-of-repeated-dose-esketamine-in-adolescents-with-maj
A Study to Evaluate the Efficacy and Safety of Intranasal Esketamine in Addition to Comprehensive Standard of Care for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Adult Participants Assessed to be at Imminent Risk for Suicide (ASPIRE I)
TrialPaperNCT03039192
Esketamine + SOC
Esketamine
84 mg
Other | multi-dose
twice weekly | 8 doses

Days 1,4,8,11,15,18,22,25 (8 doses over 4 weeks).

Not reviewed
existing-data | esketamine-nasal-spray-for-rapid-reduction-of-major-depressive-disorder-symptoms
A Study to Evaluate the Efficacy and Safety of Intranasal Esketamine in Addition to Comprehensive Standard of Care for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Adult Participants Assessed to be at Imminent Risk for Suicide (ASPIRE II)
TrialPaperNCT03097133
Esketamine + Standard of care
Esketamine
84 mg
Other | multi-dose
two times per week | 8 doses

Intranasal administration on Days 1, 4, 8, 11, 15, 18, 22, and 25.

Not reviewed
existing-data | esketamine-nasal-spray-for-rapid-reduction-of-depressive-symptoms-in-patients-wi
A Study to Evaluate the Efficacy, Pharmacokinetics, Safety and Tolerability of Flexible Doses of Intranasal Esketamine Plus an Oral Antidepressant in Adult Participants With Treatment-resistant Depression
TrialPaperNCT03434041
Esketamine + AD
Esketamine
56-84 mg
Other | multi-dose
twice per week | 8 doses

Intranasal spray; start 56 mg on Day 1; may be increased to 84 mg per investigator discretion.

Not reviewed
existing-data | efficacy-and-safety-of-flexibly-dosed-esketamine-nasal-spray-plus-a-newly-initia
A Study to Evaluate the Efficacy, Safety, and Tolerability of Fixed Doses of Intranasal Esketamine Plus an Oral Antidepressant in Adult Participants With Treatment-resistant Depression (TRANSFORM-1)
TrialPaperNCT02417064
Esketamine 56 mg
Esketamine
56 mg
Other
twice per week | 8 doses

Fixed 56 mg dosing twice weekly.

Not reviewed
existing-data | treatment-response-with-esketamine-nasal-spray-plus-an-oral-antidepressant-in-pa
A Study to Evaluate the Efficacy, Safety, and Tolerability of Fixed Doses of Intranasal Esketamine Plus an Oral Antidepressant in Adult Participants With Treatment-resistant Depression (TRANSFORM-1)
TrialPaperNCT02417064
Esketamine 84 mg
Esketamine
84 mg
Other
twice per week | 8 doses

Day 1 56 mg then 84 mg from Day 4 onwards per protocol titration.

Not reviewed
existing-data | treatment-response-with-esketamine-nasal-spray-plus-an-oral-antidepressant-in-pa
A Study to Evaluate the Efficacy, Safety, and Tolerability of Flexible Doses of Intranasal Esketamine Plus an Oral Antidepressant in Adult Participants With Treatment-resistant Depression (TRANSFORM-2)
TrialPaperNCT02418585
Esketamine + oral antidepressant
Esketamine
56-84 mg
Other
twice per week | 8 doses

Intranasal; start 56 mg Day 1; may increase to 84 mg on Day 4 and on Days 8/11; dose may be reduced for tolerability; stable after Day 15.

Not reviewed
existing-data | treatment-response-with-esketamine-nasal-spray-plus-an-oral-antidepressant-in-pa
A Study to Evaluate the Efficacy, Safety, and Tolerability of Intranasal Esketamine Plus an Oral Antidepressant in Elderly Participants With Treatment-resistant Depression (TRANSFORM-3)
TrialPaperNCT02422186
Esketamine + AD
Esketamine
28-84 mg
Intranasal
twice per week | 8 doses

Day 1 = 28 mg; Day 4 = 28 or 56 mg; subsequent doses 28, 56 or 84 mg per investigator titration based on efficacy/tolerability.

Not reviewed
existing-data | efficacy-and-safety-of-esketamine-nasal-spray-by-sex-in-patients-with-treatment-
Clinical Study of Esketamine for Improving Depressive Symptoms in Patients With Lung Cancer After Smoking Cessation
TrialPaperChiCTR2300068591
Esketamine
Esketamine
0.5 mg/kg
Intranasal | multi-dose
weekly | 8 doses

Administered once a week for 8 sessions

Not reviewed
existing-data | efficacy-and-safety-of-esketamine-for-smoking-cessation-among-patients-diagnosed
Effect of a single low-dose dose of esketamine on postpartum depression and quality of recovery in women undergoing cesarean section: a prospective, randomised controlled study
TrialPaperChiCTR2400088992
Esketamine group
Esketamine
0.2 mg/kg
IV | fixed
single dose | 1 dose

Infused over 40 minutes immediately after fetal delivery and umbilical cord ligation; combined with PCIA for pain relief maintenance.

Not reviewed
existing-data | single-low-dose-esketamine-improves-postpartum-depression-symptoms-and-recovery-quality-in
ESKALE: descriptive study of patients with treatment-resistant depression treated with esketamine, within the framework of the cohort ATU, the post-ATU program or the post-marketing period
TrialPaperF20210125145040
Esketamine
Esketamine
Not reported
intranasal
null

Used in a real-world, non-interventional study (ESKALE) for patients with treatment-resistant depression.

Not reviewed
effectiveness-and-factors-associated-with-esketamine-response-during-the-4-week-induction-period
Esketamine vs Midazolam for MDD with Fluctuating Antidepressant Response: A Double-Blind Pilot RCT (Xiao 2023, Beijing Anding Hospital)
TrialPaperChiCTR2100050335
Esketamine-treated group
Esketamine
0.2 mg/kg
IV | fixed
single dose | 1 dose

Administered over 40 minutes via syringe pump; participants maintained ongoing adequate antidepressant treatment (ADT).

Not reviewed
existing-data | esketamine-vs-midazolam-in-boosting-the-efficacy-of-oral-antidepressants-for-maj
Oral Esketamine for Severe TRD: Multicenter Compassionate Use Open-Label Study (Veraart 2025, Netherlands)
TrialPaperVERAART-2025-JPSYCHOPHARM-ORAL-ESKETAMINE-TRD-NL
Oral esketamine
Esketamine
0.5 mg/kg
Oral | titrated
twice weekly | 12 doses

Doses were individually titrated from 0.5 or 1 mg/kg up to a maximum of 2.0 mg/kg (June 2017–April 2019) or 3.0 mg/kg (May 2019–June 2023).

Not reviewed
existing-data | oral-esketamine-for-patients-with-severe-treatment-resistant-depression-effectiv
Racemic Ketamine vs S(+)-Esketamine for TRD: Bicentric Double-Blind RCT (UFBA Brazil, UMIN000032355)
TrialPaperUMIN000032355
Esketamine
Esketamine
0.25 mg/kg
IV | fixed
single dose | 1 dose

Infusion duration of 40 min

Not reviewed
existing-data | neurocognitive-aspects-of-ketamine-and-esketamine-on-subjects-with-treatment-res
Study to Evaluate the Efficacy and Safety of 3 Fixed Doses of Intranasal Esketamine in Addition to Comprehensive Standard of Care for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Pediatric Participants Assessed to be at Imminent Risk for Suicide
TrialPaperNCT03185819
Esketamine 28 mg
Esketamine
28 mg
Other | multi-dose
three doses

28 mg delivered as 2 x 14 mg sprays.

Not reviewed
existing-data | effect-of-esketamine-on-depressive-symptoms-in-adolescents-with-major-depressive
Study to Evaluate the Efficacy and Safety of 3 Fixed Doses of Intranasal Esketamine in Addition to Comprehensive Standard of Care for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Pediatric Participants Assessed to be at Imminent Risk for Suicide
TrialPaperNCT03185819
Esketamine 56 mg
Esketamine
56 mg
Other | multi-dose
three doses

56 mg delivered as 4 x 14 mg sprays.

Not reviewed
existing-data | effect-of-esketamine-on-depressive-symptoms-in-adolescents-with-major-depressive
Study to Evaluate the Efficacy and Safety of 3 Fixed Doses of Intranasal Esketamine in Addition to Comprehensive Standard of Care for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Pediatric Participants Assessed to be at Imminent Risk for Suicide
TrialPaperNCT03185819
Esketamine 84 mg
Esketamine
84 mg
Other | multi-dose
three doses

84 mg delivered as 6 x 14 mg sprays (3 per nostril) as described.

Not reviewed
existing-data | effect-of-esketamine-on-depressive-symptoms-in-adolescents-with-major-depressive

Limitations

  • Rows are drawn from structured clinical trial intervention records linked to human clinical papers; absence from this table is not proof that a source never reported dosing.
  • Dose units are preserved as reported, so mg, mg/kg, ml/kg, and other units should not be read as directly comparable.
  • 3 target-compound intervention rows did not have a displayable numeric dose and remain visible through coverage status rather than guessed.
  • 1 dose row still carries a needs-review marker from the source review workflow.
  • This summary covers 32 eligible clinical source papers currently linked to the pair.
  • This page is an evidence navigation aid and does not recommend dosing.

Source papers

Esketamine Nasal Spray versus Quetiapine for Treatment-Resistant Depression
New England Journal of Medicine | 2023
Long-term treatment with esketamine nasal spray in patients with treatment resistant depression: Results from the ESCAPE-LTE study
European Neuropsychopharmacology | 2026
Safety and Efficacy with Esketamine in Treatment-Resistant Depression: Long-Term Extension Study
International Journal of Neuropsychopharmacology | 2025
Adverse Events and Measurement of Dissociation after the First Dose of Esketamine in Patients with TRD
International Journal of Neuropsychopharmacology | 2022
Oral esketamine in patients with treatment-resistant depression: a double-blind, randomized, placebo-controlled trial with open-label extension
Molecular Psychiatry | 2024
Esketamine Monotherapy in Adults With Treatment-Resistant Depression: A Randomized Clinical Trial
JAMA Psychiatry | 2025
Short-term cognitive effects of repeated-dose esketamine in adolescents with major depressive disorder and suicidal ideation: a randomized controlled trial
Child and Adolescent Psychiatry | 2023
Esketamine Nasal Spray for Rapid Reduction of Major Depressive Disorder Symptoms in Patients Who Have Active Suicidal Ideation With Intent: Double-Blind, Randomized Study (ASPIRE I)
Journal of Clinical Psychiatry | 2020
Esketamine Nasal Spray for Rapid Reduction of Depressive Symptoms in Patients With Major Depressive Disorder Who Have Active Suicide Ideation With Intent: Results of a Phase 3, Double-Blind, Randomized Study (ASPIRE II)
International Journal of Neuropsychopharmacology | 2020
Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Plus a Newly Initiated Oral Antidepressant in Adult Patients with Treatment-Resistant Depression: A Randomized, Double-Blind, Multicenter, Active-Controlled Study Conducted in China and USA
American Journal of Psychiatry | 2023
Treatment Response With Esketamine Nasal Spray Plus an Oral Antidepressant in Patients With Treatment-Resistant Depression Without Evidence of Early Response: A Pooled Post Hoc Analysis of the TRANSFORM Studies
Journal of Clinical Psychiatry | 2021
Efficacy and safety of esketamine nasal spray by sex in patients with treatment-resistant depression: findings from short-term randomized, controlled trials
Archives of Women's Mental Health | 2022

Source trials

A Long-term Comparison of Esketamine Nasal Spray Versus Quetiapine Extended Release, Both in Combination With a Selective Serotonin Reuptake Inhibitor/​Serotonin-Norepinephrine Reuptake Inhibitor, in Participants With Treatment Resistant Major Depressive Disorder (ESCAPE-TRD)
CTG | NCT04338321
A Long-Term Extension Study for Participants With Treatment-resistant Major Depressive Disorder Who Are Continuing Esketamine Nasal Spray Treatment
CTG | NCT04829318
A Long-term Safety Study of Esketamine Nasal Spray in Treatment-resistant Depression (SUSTAIN-3)
CTG | NCT02782104
A Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression (SUSTAIN-2)
CTG | NCT02497287
A randomised controlled trial of oral S-ketamine as add-on medication for patients with treatment-resistant major depressive disorder
Other | NL6030
A Study of Esketamine Nasal Spray, Administered as Monotherapy, in Adult Participants With Treatment-resistant Depression
CTG | NCT04599855
A Study to Evaluate the Efficacy and Safety of Esketamine Combined With Oral Antidepressants in the Treatment of Major Depressive Disorder With Suicidal Ideation
ChiCTR | ChiCTR2000041232
A Study to Evaluate the Efficacy and Safety of Intranasal Esketamine in Addition to Comprehensive Standard of Care for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Adult Participants Assessed to be at Imminent Risk for Suicide (ASPIRE I)
CTG | NCT03039192
A Study to Evaluate the Efficacy and Safety of Intranasal Esketamine in Addition to Comprehensive Standard of Care for the Rapid Reduction of the Symptoms of Major Depressive Disorder, Including Suicidal Ideation, in Adult Participants Assessed to be at Imminent Risk for Suicide (ASPIRE II)
CTG | NCT03097133
A Study to Evaluate the Efficacy, Pharmacokinetics, Safety and Tolerability of Flexible Doses of Intranasal Esketamine Plus an Oral Antidepressant in Adult Participants With Treatment-resistant Depression
CTG | NCT03434041
A Study to Evaluate the Efficacy, Safety, and Tolerability of Fixed Doses of Intranasal Esketamine Plus an Oral Antidepressant in Adult Participants With Treatment-resistant Depression (TRANSFORM-1)
CTG | NCT02417064
A Study to Evaluate the Efficacy, Safety, and Tolerability of Flexible Doses of Intranasal Esketamine Plus an Oral Antidepressant in Adult Participants With Treatment-resistant Depression (TRANSFORM-2)
CTG | NCT02418585