Systematic review · 2026
Review of esketamine for depression in people with cancer
- Original title
- The application of esketamine in cancer-related depressive states: attention from mechanisms to clinical translation.
- Authors
- Chen L, Chen Y, Zhao Y, et al.
- Journal
- Frontiers in psychiatry, 2026
- Molecules
- Esketamine
- Conditions
- Depression, Other
- Evidence grade
- Very low
- Source
- Read the original paper
The question
Can esketamine, a fast-acting antidepressant related to ketamine, help with depression in people living with cancer, and how safe is it in that group?
What they did
The authors searched PubMed, Web of Science and the Cochrane Library for research on esketamine and cancer-related depression. They pulled together laboratory work on how the drug acts in the brain, clinical trials, and earlier review articles. They then compared esketamine’s reported effects and side effects with those of older antidepressants.
What they found
The review describes several possible biological mechanisms, including blocking the NMDA receptor (a brain signalling site for the chemical glutamate), raising levels of BDNF (a protein linked to nerve cell growth), and changes in how brain connections adapt. The authors report that existing studies suggest esketamine may act quickly against depressive symptoms in cancer patients, especially around the time of surgery. Reported side effects were transient dissociation (feeling detached from one’s body or surroundings) and raised blood pressure, which the authors describe as generally manageable. No pooled effect sizes, number of included studies or participant numbers are given in the abstract.
The fine print
The abstract gives no figures at all: no number of studies, no participants, no effect sizes and no safety rates, so readers cannot judge the strength of the underlying evidence. Reviews like this can be shaped by which studies the authors chose to include. The authors themselves note that long-term safety, best dosing and use in different cancer groups remain unresolved. This summary is based only on the published abstract.
What it means
There is a plausible biological rationale and some early clinical signal for esketamine in cancer-related depression, but this review does not provide the hard numbers needed to judge how well it actually works or how safe it is over time.
Evidence grade: Very low. A literature review that reports no pooled numbers, no count of included studies and no participant totals, so its conclusions cannot be checked against data.
This summary is based on the study’s published abstract.