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Note: the response to B3 must refer to the present, whereas the response to B10 may reflect the past 24 hours. If the screening period is longer than 24 hours, assessment of B3 and B10 of MINI must be repeated prior to randomization to confirm eligibility\n* Participant has a Montgomery Asberg Depression Rating Scale (MADRS) total score of greater than (\\>) 28 predose on Day 1\n* As part of standard of care treatment, participant agrees to be hospitalized voluntarily for a recommended period of 5 days after randomization (may be shorter or longer if clinically warranted in the investigator's opinion) and take prescribed non-investigational antidepressant therapy(ies) for at least the duration of the double-blind treatment phase (Day 25)\n* Participant is comfortable with self-administration of intranasal medication and able to follow instructions provided\n\nExclusion Criteria:\n\n* Participant has a current DSM-5 diagnosis of bipolar (or related disorders), antisocial personality disorder, or obsessive compulsive disorder\n* Participant currently meets DSM-5 criteria for borderline personality disorder. Participant not meeting full DSM-5 criteria for borderline personality disorder but exhibiting recurrent suicidal gestures, threats, or self-mutilating behaviors should also be excluded\n* Participant has a current clinical diagnosis of autism, dementia, or intellectual disability\n* Participant has a current or prior DSM-5 diagnosis of a psychotic disorder, or MDD with psychotic features\n* Participant meets the DSM-5 severity criteria for moderate or severe substance or alcohol use disorder, (except for nicotine or caffeine), within the 6 months before screening. A history (lifetime) of ketamine, phencyclidine (PCP), lysergic acid diethylamide (LSD), or 3, 4-methylenedioxy-methamphetamine (MDMA) hallucinogen-related use disorder is exclusionary",false,"ALL","18 Years","64 Years",{"count":567,"type":568},226,"ACTUAL","INTERVENTIONAL",[571],"PHASE3","The purpose of the study is to evaluate the efficacy of intranasal esketamine 84 milligram (mg) compared with intranasal placebo in addition to comprehensive standard of care in reducing the symptoms of Major Depressive Disorder (MDD), including suicidal ideation, in participants who are assessed to be at imminent risk for suicide, as measured by the change from baseline on the Montgomery-Asberg Depression Rating Scale (MADRS) total score at 24 hours post first dose.",[574],"Depressive Disorder, Major","COMPLETED","2025-04-25",{"date":578,"type":568},"2025-04-29",{"date":580,"type":568},"2017-06-09",{"date":582,"type":568},"2018-12-18",{"name":5,"class":6},56]