Is there an independant anti-suicidal effect of esketamine in treatment resistant depression?
Michel Danon, Gabriela Ostronoff, Anne-Cécile Petit, Pierre De Maricourt, Jakub M Kopeć, Lila Mekaoui, Lucie Berkovitch, Philip Gorwood
Journal of Affective Disorders May 1, 2026 DOI: 10.1016/j.jad.2026.121181 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Sample size | 261 |
| Population | Adults with moderate-to-severe treatment-resistant depression at Sainte-Anne Hospital, Paris, France |
| Intervention | Intranasal esketamine |
| Duration | Eight esketamine sessions over four weeks |
| Topics | Depression Esketamine |
| Keywords | Suicide |
| Key findings | The anti-suicidal effect of esketamine does not persist once its antidepressant effect is taken into account. |
Abstract
Regulatory approvals for intranasal esketamine in treatment-resistant depression (TRD) differ with respect to its indication for suicidal ideation. While rapid antidepressant effects are well documented, whether esketamine exerts an anti-suicidal effect independent of mood improvement remains unclear. In this two-center observational study, 261 adults with moderate-to-severe TRD at Sainte-Anne Hospital, Paris, France, received eight esketamine sessions over four weeks. MADRS-D (items 1-9) and MADRS-S (item 10) were rated before each session. Both MADRS-D (all p < .001) and MADRS-S (all p < .001) improved during esketamine treatment. In multivariate analysis, depressive improvement remained significant after adjusting for MADRS-S (all p < .001), whereas the reduction in suicidal ideation lost significance when adjusting for MADRS-D (all p > .949) in both samples. Our results suggest that the anti-suicidal effect of esketamine does not persist once its antidepressant effect is taken into account.
Comparable studies
Other observational and cohort studies on esketamine for depression, most cited first.
Citations in the library
Cited by 2
- Real-world clinical practice, effectiveness and safety of esketamine nasal spray in major depressive disorder patients: a French prospective cohort (ELLIPSE study) Therapeutic Advances in Psychopharmacology August 1, 2026
- Suicidal ideation covaries with depressive severity during six-month real-world esketamine treatment in a cohort enriched for borderline personality disorder. Journal of Affective Disorders August 20, 2026
Cites 5
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