Discussion
MDD, TRD, depressive symptoms
This double-blind, pilot randomized clinical trial assessed the efficacy and safety of a subanesthetic dose of esketamine for treating FAD and found that esketamine was more effective than midazolam, with a good safety profile. Efficacy duration of a single subanesthetic dose of esketamine for treating MDD, including TRD, is approximately 10 to 14 days, with limited studies suggesting longer-lasting effects.The mechanism of ketamine and its enantiomers in exerting antidepressant effects is unclear, and few studies have reported the underlying interaction between ketamine and antidepressants. A study by Dean et alAdditionally, ketamine can alleviate depressive symptoms by restoring the lost prefrontal synaptic spines, which may partially explain the sustained antidepressant effects observed in our study.