What is it about?

Ketamine is a medication originally used for anesthesia. Ketamine, and its enantiomer esketamine, has recently shown rapid effects in treating depression and suicidal thoughts. While they are increasingly used in adults, much less is known about their safety and effectiveness in children and adolescents. This review explains how these medications work, how they are given, and what current research shows about their benefits and risks in younger populations. It also highlights important concerns, such as side effects, long-term safety, and the need for careful monitoring.

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Why is it important?

Rates of depression and suicidality among children and adolescents continue to rise, and many young patients do not respond to standard treatments. Ketamine and esketamine represent a major shift in psychiatry because they can work rapidly, often within hours to days, compared with traditional antidepressants. However, most evidence comes from adult studies, and there are important unanswered questions about safety, long-term effects, and appropriate use in younger populations. This review is timely because it brings together emerging pediatric data and clinical considerations to help guide clinicians navigating these complex decisions.

Perspectives

As clinicians, we have seen firsthand the challenges of treating severe depression in adolescents who do not respond to conventional therapies. Ketamine offers a promising option, particularly in urgent situations involving suicidality. However, its use requires careful judgment given the limited evidence in adolescent psychiatry. In this review, our goal was to provide a balanced, clinically grounded synthesis that highlights both the potential and the uncertainties. We hope this work helps clinicians make informed decisions while also encouraging further research to better define the role of ketamine in pediatric psychiatry.

Thomas Pak
University of Texas Southwestern Medical Center

Read the Original

This page is a summary of: Use of Ketamine and Esketamine in the Pediatric Population: Current Evidence and Clinical Applications, FOCUS The Journal of Lifelong Learning in Psychiatry, April 2026, American Psychiatric Association,
DOI: 10.1176/appi.focus.20250040.
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