Introduction The role of dissociation in mediating antidepressant response to intranasal esketamine remains debated. While dissociative experiences are often observed during treatment, their predictive value for clinical outcomes is uncertain. Objectives We aimed to assess whether (i) baseline dissociative traits (DES-II) and (ii) early changes in dissociation (ΔDES T0→T2) predict short-term...
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...
Major depressive disorder (MDD) is a leading cause of disability worldwide and contributes significantly to the global burden of disease. Recent data show an increasing prevalence of treatment-resistant depression (TRD). Patients with autism spectrum disorder (ASD) often exhibit MDD as a comorbidity and it is often resistant to conventional treatments. ASD determines emotional dysregulation and...
Background/Objectives: Esketamine-related dissociation is a transient, pharmacologically induced altered state that differs from the trait-like pathological dissociation typically observed in trauma-related conditions. While most studies have quantified these effects using the Clinician-Administered Dissociative States Scale (CADSS), patients' subjective phenomenology and meaning-making remain...
Background: Suicidal ideation (SI) represents a clinical challenge in patients with treatment-resistant depression (TRD), and the management of this condition should be as rapid and effective as possible. Intranasal Esketamine has shown promise in patients with TRD due to its rapid onset of action on both SI and depressive symptoms. Since this medication has been recently approved, real-world...
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,...
Major depression is a common comorbidity in autism spectrum disorder (ASD), often difficult to identify and to treat. Autistic subjects are more at risk for suicidal thoughts and behaviors compared to typically developing peers. Unfortunately, ASD individuals are more frequently treatment-resistant and often show side-effects which reduce efficacy. Intranasal esketamine has been recently...
The psychosis spectrum comprises heterogeneous disorders characterized by both world-related and self-related symptoms. How these symptoms may arise with similar features in spite of the different aetiologies is yet an unsolved question. In behavior narrative review, we compare three conditions characterized by psychotic experiences (schizophrenia, substance-use disorder and...