Patient Experience with Intranasal Esketamine in Treatment-Resistant Depression: Insights from a Multicentric Italian Study (REAL-ESKperience)
Marco Di, M. Pepe, Giacomo D’andrea, Ilaria Marcelli, Mauro Pettorruso, Ileana Andriola, Stefano Barlati, Matteo Carminati, C. I. Cattaneo, Massimo Clerici, D. D. Berardis, S. Filippis, Bernardo Dell'Osso, Giorgio Di Lorenzo, Giuseppe Maina, M. Manchia, Matteo Marcatili, V. Martiadis, C. Niolu, Antonino Petralia, Gianluca Rosso, Gianluca Serafini, M. Signorelli, Tommaso Vannucchi, M. Vismara, Raffaella Zanardi, Antonio Vita, Gabriele Sani, Giovanni Martinotti, Real-Esk Study Group
Journal of Personalized Medicine April 1, 2025 DOI: 10.3390/jpm15040161 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 236 |
| Population | Outpatients with treatment-resistant depression treated with esketamine nasal spray for at least three months |
| Intervention | Esketamine nasal spray |
| Duration | At least three consecutive months |
| Topics | Depression Esketamine |
| Citations | 18 |
| Key findings | Most patients reported positive perceptions of esketamine nasal spray, with the most satisfied participants highlighting significant benefits to depressed mood, suicidal thoughts, and overall functioning. |
Abstract
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, focusing on perceived therapeutic effects and overall satisfaction. Methods. A self-report survey was administered to 236 outpatients with TRD (55.1% females, 54.1 ± 14.1 years) treated with ESK-NS for at least three consecutive months within standard clinical care. Based on satisfaction levels, participants were classified as “unsatisfied” (10.2%), “partially satisfied” (19.1%), “satisfied” (44.4%), or “very satisfied” (26.3%), and compared for sociodemographic, clinical characteristics, and feedback on perceived benefits. Artificial intelligence (OpenAI) served to categorize responses to an open-ended question. Results. Enhanced quality of life was reported by 88.4% of participants. Significant differences emerged in earliest self-perceived benefits, most relevant effects, and impact on global functioning across groups. Specifically, “very satisfied” patients described the following: early improvements in depressed mood, suicidal thoughts, and restlessness; decreased suicidal thoughts among the most significant effects; and functional gains across all domains. OpenAI identified experiences of personal growth and rediscovery and a desire for tailored settings and approaches as recurring topics. Conclusions. Most patients reported a positive perception of ESK-NS treatment. The most satisfied participants highlighted significant benefits to depressed mood, suicidal thoughts, and overall functioning. Patient-reported experiences offer insights into different psychopathological dimensions, including functional outcomes and quality of life. Integrating these perspectives into clinical practice might assist treatment personalization, improving patients’ adherence and satisfaction.
Comparable studies
Other observational and cohort studies on esketamine for depression, most cited first.