Esketamine nasal spray (NS) is an established treatment for patients with treatment resistant depression (TRD). To further optimise real-world outcomes, consensus is needed regarding strategies to enhance patient outcomes and decision-making factors for pivotal timepoints in esketamine NS treatment. This modified Delphi panel (3 rounds) established expert consensus (≥80% agreement) from 30...
European PsychiatryJune 1, 2026Jesús García-Jiménez, S. Posik, B. Herrejón et al.
Introduction Treatment-resistant depression (TRD) is highly burdensome. Intranasal esketamine is effective, yet hospital-centric delivery adds travel and continuity barriers that may hinder adherence and outcomes. We hypothesize that community outpatient, patient-proximal delivery —often with the patient’s usual psychiatrist—improves effectiveness, engagement and acceptability, consistent with...
The trajectory and predictors of response under routine clinical care of esketamine nasal spray (ESK NS) over treatment-resistant depression (TRD) require elucidation. This retrospective, longitudinal cohort study was conducted across three Spanish centers. Adults diagnosed with TRD who initiated ESK NS and completed at least the induction phase were included. Assessments occurred at baseline,...
Frontiers in PsychiatryAugust 4, 2025Fernando Mora, J. Ramos-Quiroga, Enrique Baca-García et al.5 citations
Introduction Depression is a highly prevalent disease that severely impacts the life of patients. Inadequate response to at least two antidepressants despite adequacy of treatment and adherence is known as treatment-resistant depression (TRD), which entails a higher social and economic burden than non-resistant major depression. The lack of consensus on the definition of TRD and other aspects...
Mindfulness based interventions (MBIs) are increasingly recognised for their efficacy in treating depressive disorders. Depressive symptoms are prevalent across various disorders and can significantly impact outcomes, therefore being an important transdiagnostic target. Multiple randomized controlled Trials (RCTs) have explored this question in discrete disorders; however, evidence has never...
Treatment-resistant depression (TRD) is defined as the failure of at least two antidepressants in adequate doses and timing during a major depressive episode. Esketamine intranasal (ESK-IN) has been approved by the Food and Drug Administration and the European Medicines Agency for the treatment of TRD in combination with other antidepressants. To assess the effectiveness and tolerability of a...
Ketamine and its enantiomer S-ketamine (esketamine) are promising candidates to produce a rapid-onset antidepressant effect in treatment-resistant depression. Ketamine causes continued blockade of the glutamate N-methyl-D-aspartate (NMDA) receptor, though this might not primarily mediate the antidepressant effect. Alternative hypotheses include selectivity for the NMDA receptor subtype...
The rapidly-acting antidepressant properties of ketamine are a trend topic in psychiatry. Despite its robust effects, these are ephemeral and can lead to certain adverse events. For this reason, there is still a general concern around the off-label use of ketamine in clinical practice settings. Nonetheless, for refractory depression, it should be an indication to consider. We report the case of...
Esta es la segunda parte de una revisión sobre los efectos adversos que presenta el consumo de cannabis sobre la salud de los jóvenes. La primera parte trató sobre los efectos adversos para la salud física y esta segunda parte trata de los efectos adversos sobre la salud psíquica. El cannabis ha sido considerado a veces como una droga relativamente menos peligrosa que otras, y además se le han...