Systematic review and meta-analysis of intranasal esketamine for treatment-resistant depression: Evidence from real-world studies

This study provides consistent real-world evidence supporting that Intranasal esketamine was associated with meaningful symptom reduction and rising remission rates over time in real-world settings. Given the observational nature of the evidence and the absence of control groups, effect sizes should be interpreted with caution. Nonetheless, these findings provide valuable insight into esketamine's effectiveness and tolerability in routine practice and highlight the need for controlled comparative studies to guide long-term treatment strategies.