Comparison of ketamine infusion, intranasal esketamine spray and repetitive Transcranial Magnetic Stimulation (rTMS) for treatment-resistant depression at a suburban tertiary clinic

Background: Ketamine infusion therapy and esketamine intranasal therapy are two emerging treatments in the field of treatment-resistant depression (TRD). The efficacy of these two treatments have not been widely studied in practical clinical settings. We used retrospective clinical data to compare remission rates for patients treated for TRD with ketamine or esketamine compared to rTMS. We examined outcomes of patients with TRD after five weeks of treatment with ketamine infusion; intranasal esketamine; or rTMS to compare their relative effectiveness in an outpatient setting.