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Case Report: Intranasal esketamine combined with a form of generative artificial intelligence in the management of treatment-resistant depression.

Alexandre Fraichot, Sophie Favre, Hélène Richard-Lepouriel

Frontiers in Psychiatry 2025 DOI: 10.3389/fpsyt.2025.1536232 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population 37-year-old patient with treatment-resistant depression
Intervention Intranasal Esketamine
Dose 84 mg
Topics Depression Esketamine
Keywords Artificial intelligence Case report Intranasal esketamine
Citations 1
Key findings Combining intranasal Esketamine with generative artificial intelligence images and interpretations, supported by a nurse, led to remission from depression in a patient with treatment-resistant depression.

Abstract

Intranasal Esketamine is an effective rapid-acting antidepressant currently used to treat treatment-resistant depression. Artificial intelligence is another emerging tool in medicine, but little is known about the effectiveness of combining these innovations in psychiatry. This case report presents the outcome of a 37-year-old patient who received intranasal Esketamine treatment (84 mg) and utilized artificial intelligence (ChatGPT-4) to generate images and interpretations of his experiences with dissociation. This process was conducted in the presence of a nurse who assessed and supported the patient. The Montgomery-Åsberg Depression Rating Scale (MADRS) was used to measure the severity of depression at the beginning of each session. The patient achieved remission from depression, with MADRS scores declining by 50% in the third session, and the scores indicated mild depression or euthymia in the eight subsequent sessions. The patient reported that incorporating artificial intelligence-generated images and interpretations helped him create a timeline of his experiences at the end of each session. This case report highlights the potential effectiveness of combining intranasal Esketamine treatment with generative artificial intelligence images and interpretations as part of an integration process. It also emphasizes the importance of having a nurse present to support the process. Further research is needed to determine which patients may benefit most from this combined treatment approach.

Comparable studies

Other case reports and case series on esketamine for depression, most cited first.

Study Year Design Participants
Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
Effects of intranasal (S)-ketamine on Veterans with co-morbid treatment-resistant depression and PTSD: A retrospective case series Veterans with co-morbid depression and PTSD 2022 Retrospective case series n = 35
Case report: Intramuscular ketamine or intranasal esketamine as a treatment in four patients with major depressive disorder and comorbid anorexia nervosa Patients with anorexia nervosa and a comorbid depressive disorder treated at a private... 2023 Case report n = 4
Repeated oral esketamine in patients with treatment resistant depression and comorbid posttraumatic stress disorder Patients with treatment-resistant depression and comorbid PTSD 2023 Case series n = 5
Disembodiment and Affective Resonances in Esketamine Treatment of Depersonalized Depression Subtype: Two Case Studies. Patients with treatment resistant depression and depersonalized depression symptoms 2024 Case study n = 2

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