Beyond first-line antidepressants: lithium, quetiapine, or esketamine? Integrating meta-analyses and preliminary head-to-head evidence

The results generally argue for a re-evaluation of existing treatment algorithms in guidelines. However, since all three are fundamentally different molecules with different pharmacokinetic and pharmacodynamic properties and differ in (1) side effects and contraindications as well as (2) profile focus, embedding them in a comprehensive clinical context is important.