Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Esketamine(click to collapse)
1/4 selected
Esketamine
Spravato
NMDA Receptor Antagonist · C-III
FDA-approved indications
- Treatment-resistant depression — mono or with oral antidepressant (adults)
- MDD with acute suicidal ideation/behavior — with oral antidepressant (adults)
Off-label uses
- Chronic pain (subanesthetic)
- Acute suicidality in non-MDD conditions
Half-life7 to 12 hours
Decision GuideWhen to pick each / when to consider an alternative
Esketamine
Consider when
- Treatment-resistant depression — FDA-approved (Spravato) for TRD in adults in conjunction with oral antidepressant; only FDA-approved ketamine formulation for depression
- MDD with acute suicidal ideation or behavior — FDA-approved for this indication; rapid onset of antidepressant effect
- Standardized clinical protocol desired — REMS program ensures supervised administration; 2-hour monitoring post-dose
- Intranasal delivery preferred — self-administered under supervision; avoids IV infusion complexity of racemic ketamine
- +1 more
Consider an alternative when
- Dissociation is intolerable — 41% experience dissociation (CADSS); sedation 48–61% during monitoring period
- Cannot attend REMS-certified clinic — must be administered in certified healthcare setting with 2-hour monitoring; not take-home
- Uncontrolled hypertension — transient BP elevations during administration; monitor BP before and after each dose
- Active substance use disorder — abuse potential; dissociative effects are reinforcing; Schedule III controlled substance
- +1 more
| Axis | Esketamine NMDA-antagonist |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Abuse / addiction liability | |
Respiratory depression (opioid / CNS depressant co-use) | |
| CNS | |
Sedation / somnolence | |
Cognitive dulling / anterograde amnesia | |
Dizziness | |
| Cardiac | |
Blood pressure elevation | |
Heart rate / tachycardia | |
| GI | |
Nausea / GI (general) | |
| Drug-specific / distinctive axes | |
Dissociation (BBW — DISTINCTIVE defining axis) only in Esketamine | |
Urinary tract effects (W&P §5.10 — DISTINCTIVE) only in Esketamine | |