European Psychiatry
June 1, 2026
V. Martiadis, Fabiola Raffone, Serena Testa et al.
Introduction Treatment-resistant depression (TRD) is a severe condition associated with high suicide risk and limited response to conventional antidepressants. Intranasal esketamine has shown rapid efficacy in reducing depressive symptoms and suicidal ideation. Objectives This observational study assessed the real-world effectiveness of esketamine in reducing suicidal ideation, self-harm...
European Psychiatry
June 1, 2026
Giada Versaci, Miriam Olivola, Kevin la Monica et al.
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...
European Psychiatry
June 1, 2026
V. Casati, Kevin la Monica, Mauro Angeletti et al.
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...
European Psychiatry
June 1, 2026
Miriam Olivola, V. Martiadis, Kevin la Monica et al.
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...
Journal of Affective Disorders
September 1, 2025
Miriam Olivola, Filippo Mazzoni, Barbara Tarantino et al.
8 citations
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...
Psychiatry Research
July 26, 2025
Giacomo D’andrea, Clara Cavallotto, Mauro Pettorruso et al.
16 citations
INTRODUCTION Anhedonia, defined as the diminished ability to experience or anticipate pleasure, is a core symptom of major depressive disorder (MDD) and bipolar depression (BD), and associated with depression severity, suicidality and poor treatment outcomes. Conventional antidepressants demonstrate limited efficacy against anhedonia. Esketamine nasal spray (ESK-NS) - a novel NMDA receptor...
Journal of Personalized Medicine
April 1, 2025
Marco Di, M. Pepe, Giacomo D’andrea et al.
18 citations
Background. Treatment-resistant depression (TRD) is a prevalent, high-burden disorder. Esketamine nasal spray (ESK-NS) has been approved for, T.R.D.; and efficacy has been observed in both clinical trials and real-world studies. However, observations integrating patients’ perspective on this treatment are limited. This multicentric Italian study explored experiences with ESK-NS in TRD patients,...