Esketamine use in real-world clinical practice in patients with treatment-resistant depression.
Ismaël Conejero, Raquel Alvarez García, Alejandro Porras-Segovia, Ana María De Granda-Beltrán, Sergio Benavente López, Ezequiel Di Stasio, Lucía Albarracín-garcía, Jorge Lopez-Castroman, Philippe Courtet, Enrique Baca-García
European Psychiatry August 26, 2025 DOI: 10.1192/j.eurpsy.2025.10096 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Naturalistic study Peer reviewed |
|---|---|
| Sample size | 65 |
| Population | Patients aged over 18 with treatment-resistant depression receiving esketamine augmentation treatment |
| Intervention | Esketamine |
| Duration | 4-week induction phase and 5-to-8-week maintenance phase |
| Topics | Esketamine Depression |
| Keywords | Augmentation treatment Naturalistic study Treatment resistant depression |
| Citations | 2 |
| Key points | Extending the number of esketamine administrations beyond the standard protocol may increase the likelihood of remission in treatment-resistant depression. |
Abstract
Esketamine has been shown to produce a major antidepressant response in patients with treatment-resistant depression (TRD). We evaluated the factors associated with achieving remission in these individuals. The study was carried out across four psychiatry departments in Madrid, Spain. Patients aged over 18 years were included if they received esketamine as an augmentation treatment for TRD. Standard esketamine protocol included an induction phase (4 weeks) and a maintenance phase (5 to 8 weeks). Subsequent treatment continuation was proposed. Clinical data and scores at the Clinical Global Impression scales were measured following each esketamine administration. Sixty-five patients initiated the treatment, and 45 patients (69.2%) completed the standard protocol. The median number of esketamine administrations was 19. The mean age was 53.09 and 52.3% of the patients were females. Out of the whole sample, 36 (55%) of the patients achieved remission over the follow-up. Remission rates elevated to 67% in those who completed the standard protocol, and to 70% in those having received more than 19 esketamine administrations. Achieving remission over the follow-up was associated with the absence of dissociative symptoms, and with completing the standard esketamine protocol (OR = 0.229, p = 0.045; and OR = 4.538, p = 0.025, respectively). Receiving more than 19 esketamine administrations was associated with remission over the follow-up (OR = 6.513, p = 0.006). Our results suggest that extending the numbers of esketamine administration may increase the chances to obtain remission. Adverse effects did not impact the treatment course.
Comparable studies
Other observational and cohort studies on esketamine for depression, most cited first.
Citations in the library
Cited by 2
- Esketamine for treatment-resistant depression: Comparing two maintenance schedules in an observational real-world study Research Square July 9, 2026
- Clinical Predictors of Antidepressant Effects of Ketamine and Esketamine in Treatment-Resistant Unipolar and Bipolar Depression: A Systematic Review CNS Drugs July 1, 2026