Parenteral esketamine (off label)
The use of parenteral esketamine in treatment-resistant depression is considered off-label use in Brazil. According to CFM Opinion No. 20/2024, this use is ethically permitted when indicated carefully, with scientific rationale, proper documentation, and patient consent.
Legal notice
Off-label use may be considered in specific situations, with scientific rationale, proper documentation, and informed consent. Indication is individualized and requires medical follow-up.
Clinically Reviewed by:
Dr. Helio Widson Alves Pinheiro
Pain Medicine | Acupuncture
CRM/PE 21167 | RQE 2217, 2808
This content is informative and does not replace individual medical evaluation.
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Fundador da Clínica Intrador, médico especialista em Medicina da Dor e Acupuntura, com atuação em tratamentos intervencionistas e neuromodulação.
Note: This content is for educational and informational purposes only. The information is based on scientific evidence and the clinical practice of the Intrador team, but it does not replace individualized medical evaluation. Conduct, indications, and treatments must be defined after medical consultation.
Clinical reviewer: Dr. Helio Widson Alves Pinheiro · Pain Medicine | Acupuncture · CRM/PE 21167 | RQE 2217, 2808
Published on: January 17, 2026
Reviewed on: January 29, 2026
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