Adolescent-onset depression and anxiety represent a substantial, and growing, health-care burden. Unfortunately, traditional treatments for depression and anxiety that are effective in adults have small success rates in paediatric populations. 1 Therefore, there is understandable enthusiasm for novel treatments that might help young people struggling with affective disorders. In March, 2019, esketamine was approved for treatment-resistant depression in adults, and clinical trials to test its efficacy in adolescents have already begun. 2 However, considerable research from the field of schizophrenia suggests that repeated exposure to ketamine-like drugs during development can permanently disrupt neurodevelopment and have catastrophic long-term cognitive and behavioural outcomes. 3 , 4 As one of the principal prepsychotic symptoms of schizophrenia in adolescence is depression, repeated administration of esketamine as an antidepressant could represent a profound risk for at least some members of this highly vulnerable population.
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", language="en", issn="2215-0374", doi="10.1016/S2215-0366(19)30521-8", url="http://dx.doi.org/10.1016/S2215-0366(19)30521-8" }