Multimodal rapid anti-depression: Esketamine combined with dexmedetomidine patient-controlled sleep for treatment-resistant depression - A retrospective study.
Yao-Zu Li, Cai-Qun Zhao, Mu-Yan Zuo, Ruo-Guo Wang, John P Williams, Jian-Xiong An
Journal of Affective Disorders January 30, 2026 DOI: 10.1016/j.jad.2026.121311 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective cohort Peer reviewed |
|---|---|
| Sample size | 233 |
| Population | Patients with treatment-resistant depression |
| Interventions | Esketamine Dexmedetomidine patient-controlled sleep |
| Duration | 6-month follow-up |
| Topics | Depression Esketamine |
| Keywords | Dexmedetomidine Multimodal rapid anti-depression Patient-controlled sleep |
| Key findings | Multimodal therapy combining esketamine and dexmedetomidine patient-controlled sleep was associated with sustained improvements in depressive symptoms and sleep quality over 6 months, with an acceptable safety profile. |
Abstract
To evaluate the efficacy and safety of a multimodal rapid anti-depression therapy that combines esketamine treatment with dexmedetomidine patient-controlled sleep (PCSL) in patients with treatment-resistant depression (TRD). We retrospectively included 233 patients with TRD who received the multimodal treatment. Baseline clinical characteristics were collected. Follow-up assessments were conducted at 1, 3, and 6 months after the first esketamine infusion. Depressive symptoms were assessed using the Hamilton Depression Scale (HAMD), and subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Esketamine administration during the initial course, additional esketamine treatment during follow-up, and PCSL use during follow-up were recorded. Adverse events were documented. HAMD and PSQI scores decreased significantly from baseline at 1, 3, and 6 months. Antidepressant response rates at these time points were 62.00%, 59.73%, and 58.49%, respectively. In multivariable analyses, PCSL use remained associated with response at 1, 3, and 6 months. Additional esketamine treatment during follow-up was associated with response at 3 months; at 6 months, the effect estimate remained favorable, although it did not reach statistical significance. Among other variables, age and disease duration were also associated with response. No serious adverse events were observed during follow-up. In this retrospective cohort, the multimodal treatment was associated with sustained improvements in depressive symptoms and sleep quality over 6 months, with an acceptable safety profile.
Comparable studies
Other observational and cohort studies on esketamine for depression, most cited first.
Citations in the library
Cites 6
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- Antidepressant effects of esketamine via the BDNF/AKT/mTOR pathway in mice with postpartum depression and their offspring. Progress in Neuro-Psychopharmacology and Biological Psychiatry June 8, 2024
- Effect of Repeated Intravenous Esketamine on Adolescents With Major Depressive Disorder and Suicidal Ideation: A Randomized Active-Placebo-Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry May 2024
- Brain-derived neurotrophic factor serum levels following ketamine and esketamine intervention for treatment-resistant depression: secondary analysis from a randomized trial. Trends in Psychiatry and Psychotherapy March 7, 2023
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