Indications
Primary Indications
Treatment-resistant depressionMajor depressive disorder with acute suicidalityBipolar depression (investigational)PTSD (exploratory)
NMDA receptor antagonists (medicines that block a glutamate receptor called NMDA) can ease depression quickly, especially depression that has not responded to other treatments.
Ketamine and the related medicine esketamine are the most studied.
Reviewed by the HeyPsych Medical Review Board · Reviewed November 24, 2025
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Used for
Also prescribed for (off-label)
Common use
NMDA Antagonists is used for Treatment-resistant depression. The full guide below has the details.
About Treatment-resistant depressionHow many people in 100 notice each one in clinical studies. Many early side effects fade within a few weeks.
Bladder toxicity with long-term misuse
Substance misuse liability
Thoughts of suicide? Call or text 988, any time.
Everything we know about NMDA Antagonists, section by section.
9 chapters · about 9 min to read it all. Open any one.
Frequency: Typically 2 sessions/week initially; taper to maintenance as indicated.
Duration: Acute course 4–6 weeks; maintenance may extend months to years.
Total Treatment Time: Variable depending on response and relapse prevention strategy.
typical session cost: $400–$800 per ketamine infusion; $600–$900 per esketamine session
total treatment cost: Thousands of dollars per course; ongoing maintenance adds cost
insurance coverage: Esketamine covered by some insurers; ketamine typically out-of-pocket
cost effectiveness: Potentially cost-effective for rapid relief in severe TRD, but high cost limits accessibility
Durability of effect remains limited; repeated dosing protocols and long-term outcomes require further study.
This treatment information is for educational purposes only. Treatment decisions should be made in consultation with qualified healthcare professionals based on individual circumstances, symptoms, and medical history. Do not attempt treatment without professional guidance.
Thinking about NMDA Antagonists? A prescriber can tell you if it fits.
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