ArticlePsychiatric research and clinical practice2026
Real-World Effectiveness and Cost-Differential of Intranasal Esketamine Versus Intramuscular Ketamine.
Article in Psychiatric research and clinical practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Real-World Effectiveness and Cost-Differential of Intranasal Esketamine Versus Intramuscular Ketamine.Psychiatric research and clinical practice · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: This study evaluated whether intramuscular (IM) ketamine is non-inferior to intranasal (IN) esketamine for treatment-resistant depression (TRD) and assessed differences in safety and healthcare costs. Methods: In a retrospective, observational sequential cohort at the VA San Diego, 179 Veterans with TRD received eight treatments of either IN esketamine ( Results: IM ketamine was non-inferior to IN esketamine for depression, with a baseline-adjusted estimated marginal mean PHQ-9 difference of 0.04 points (95% CI: -1.21 to 1.29). Reductions in PTSD symptoms were also non-inferior. Incidence of sentinel adverse events were comparable, with no significant differences in emergency department visits or hospitalizations. Cost analysis revealed a significant disparity: the total cost per eight-treatment course was $6069 for IN esketamine versus $647 for IM ketamine, with this difference driven primarily by the cost of IN esketamine. Conclusions: IM ketamine demonstrated comparable clinical effectiveness and safety to FDA-approved IN esketamine while offering a significant reduction in cost. These findings suggest IM ketamine may be a high-value alternative to IN esketamine that could significantly expand access to psychiatric care for individuals with TRD. Relevance to Clinical Practice: These findings provide real-world evidence supporting the use of IM ketamine for TRD, and suggests that this formulation could offer a pathway for improving access to ketamine treatment by lowering the cost to healthcare systems.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.