For what it's worth, I've personally witnessed esketamine make major improvements to treatment resistant depression after a single treatment when nothing else is working worth a damn. So it's pretty clear to me that it is a real treatment with good cause for using it.
Now, it didn't work in our case because of underlying psychosis, which also means it's dangerous as heck and needs to be used carefully, but in terms of effect size, someone can go from rating their depression as 10 out of 10 down to zero in one treatment.
So I wouldn't be hasty to discard it, just careful to use it on the right people and maybe I'd figure out some way to deal with the psychosis so that those who might otherwise get excluded could have the benefits too.
Now, it didn't work in our case because of underlying psychosis, which also means it's dangerous as heck and needs to be used carefully, but in terms of effect size, someone can go from rating their depression as 10 out of 10 down to zero in one treatment.
So I wouldn't be hasty to discard it, just careful to use it on the right people and maybe I'd figure out some way to deal with the psychosis so that those who might otherwise get excluded could have the benefits too.