BACKGROUND: Patients with obsessive–compulsive disorder (OCD) and comorbid major depressive disorder (MDD) represent a severe subgroup with increased treatment resistance, greater functional impairment, and limited therapeutic options. Intranasal esketamine is a rapidly acting treatment for resistant depression, with emerging interest in potential anti-obsessional effects. However, prospective...
This case series describes the combined use of electroconvulsive therapy (ECT) and intranasal esketamine (ESK)-2 rapidly acting, evidence-based options for treatment-resistant depression (TRD). Each can leave residual symptoms or early relapse. Whether concurrent use confers more durable benefit remains unclear. We followed 4 adults (50 to 72 y) with severe TRD who had shown partial or waning...