Short-term ketamine use in bipolar depression: a review of the evidence for acute treatment management

This narrative review examines esketamine (ketamine's enantiomer) as a rapid-acting treatment option for bipolar depression, which carries high risks of suicidality and treatment resistance. Preliminary research suggests esketamine may be safe and effective as an add-on therapy with potential benefits for suicidal ideation, anhedonia, and anxiety, though evidence specific to bipolar disorder is less comprehensive than for unipolar depression.