Borderline personality disorder (BPD) often occurs alongside treatment-resistant depression (TRD), but the impact of BPD on real-world outcomes with intranasal esketamine is unclear. Consecutive TRD outpatients initiating intranasal esketamine treatment at four Italian centres between 1 September 2024 and 30 September 2025 were enrolled in the study (n = 90): 45 with comorbid BPD and 45 without...
Suicidal ideation and deliberate self-harm are frequent and persistent in treatment-resistant depression (TRD), particularly when comorbid borderline personality disorder (BPD) is present. Real-world evidence on antisuicidal outcomes during intranasal esketamine in this population remains limited. In this multicentre prospective observational study, 90 outpatients with TRD received intranasal...
Introduction Esketamine-induced dissociation is a transient, pharmacologically mediated alteration in consciousness, often distinct from pathological dissociation. While not required for clinical improvement, these states may engage neural circuits implicated in therapeutic change. Objectives This study explores patients’ lived experiences of dissociation as potentially meaningful transitional...
Introduction Intranasal esketamine has emerged as an innovative treatment for TRD due to its rapid antidepressant effects. However, the clinical response is heterogeneous, and growing evidence suggests that comorbid personality disorders (PDs) may significantly shape treatment outcomes. Although PDs are frequently diagnosed in TRD patients, little is known about their differential influence on...
INTRODUCTION Treatment-Resistant Depression (TRD) remains a major challenge in the management of Major Depressive Disorder (MDD). Esketamine, the S-enantiomer of ketamine and a glutamatergic modulator, has been approved by the FDA and EMA for TRD in 2019. Beyond its rapid antidepressant effects, esketamine may enhance neuroplasticity, facilitating the reconnection with emotional and cognitive...
Case Report Esketamine in Geriatric Depression and Pseudodementia: A Case Study Filippo Mazzoni 1,2, Giovanni Carnevale Miacca 1,2, Alessandro Guffanti 1,2, Vassilis Martiadis 3, Benardo Maria Dell’Osso 4,5,6,7, Natascia Brondino 1,2 and Miriam Olivola 1,4 1 Department of Brain and Behavioural Sciences, University of Pavia, 27100 Pavia, Italy 2 Department of Mental Health and Addiction, ASST...
Treatment-Resistant Depression (TRD) remains a major challenge in the management of Major Depressive Disorder (MDD). Esketamine, the S-enantiomer of ketamine and a glutamatergic modulator, was approved by the FDA and EMA for TRD in 2019. Beyond its rapid antidepressant effects, esketamine may enhance neuroplasticity, facilitating the reconnection with emotional and cognitive processes,...
It's well known that exotoxicosis can originate various psychiatric clinical pictures. The psychic impact of "classic" substances of abuse is well known and easily detectable with the usual methods of examination. In the last years new psychoactive substances (NPS) are spreading worldwide, determining not easily recognizable situations, with a significant clinical and organizational impact on...