Efficacy of Esketamine among patients with treatment resistant depression in a 'real world' health-care setting in Israel.
Lior Dvorak, Esther Bloemhof-Bris, Assaf Shelef, Dania Halperin, Gay Wexler, Ortal Talmon, Kfir Feffer
Journal of Psychiatric Research June 1, 2024 DOI: 10.1016/j.jpsychires.2024.04.008 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Naturalistic retrospective study Peer reviewed |
|---|---|
| Sample size | 94 |
| Population | Individuals age 18 and above diagnosed with treatment-resistant depression, treated with esketamine in an outpatient setting |
| Intervention | Esketamine |
| Dose | 28 mg to 84 mg |
| Duration | Acute phase (biweekly for 4-8 weeks) followed by maintenance phase (once a week to once a month for 6-12 months) |
| Topics | Depression Esketamine |
| Keywords | Real world study Treatment resistant depression Depression treatment Psychiatric medicine Clinical research Esketamine therapy |
| Citations | 9 |
| Key points | Esketamine treatment led to linear improvement of depressive symptoms in both acute and maintenance phases, with a similar pattern in patients with comorbid personality disorder during the acute phase but milder improvement during maintenance. |
Abstract
One in five people will likely suffer from major depressive disorder (MDD) during their life. Thirty percent of those with MDD will experience Treatment Resistant Depression (TRD), which is characterized by a failure to respond to two adequately administered trials of antidepressants. Esketamine is a rapidly acting intranasal antidepressant. Present-day Esketamine research has limited data in real-world populations. This study aimed to assess Esketamine treatment in a real-world community-based population. This naturalistic retrospective study included 94 individuals age 18 and above diagnosed with TRD, treated with Esketamine in an outpatient setting. The treatment was given in a single clinic, from January 2021 to January 2023, following approval of the Institutional Internal Review Board. The treatment included an acute phase (biweekly treatment, continuing 4-8 weeks), followed by a maintenance phase (once a week to once a month, for 6-12 months). Dosing ranged from 28 mg to 84 mg. Demographic and clinical data were retrospectively gathered. Depressive symptoms were assessed using the Quick Inventory of Depressive Symptomatology, at baseline and during each treatment phase. All patients completed the acute phase. About 60% completed the maintenance phase. Linear improvement of depressive symptoms was revealed in both phases. A sub-analysis of patients with comorbid personality disorder revealed a similar improvement pattern in the acute phase with milder improvement during the maintenance phase, compared to the other patients. This study supports the use of Esketamine for TRD, including patients with comorbid personality disorder and previous electroconvulsive therapy.
Comparable studies
Other observational and cohort studies on esketamine for depression, most cited first.
Citations in the library
Cited by 7
- Systematic review and meta-analysis of intranasal esketamine for treatment-resistant depression: Evidence from real-world studies. Journal of Affective Disorders January 28, 2026
- Fast-acting approaches for treatment-resistant depression: real-world comparative effectiveness of Intranasal Esketamine versus accelerated rTMS. International Journal of Psychiatry in Clinical Practice March 11, 2026
- 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
- Intranasal esketamine in treatment-resistant depression with and without comorbid borderline personality disorder: A multicenter real-world longitudinal study. Psychiatry Research June 16, 2026
and 2 more in the library
Cites 8
- Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study American Journal of Psychiatry May 21, 2019
- Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression JAMA Psychiatry June 5, 2019
- Rapid‐acting antidepressant ketamine, its metabolites and other candidates: A historical overview and future perspective Psychiatry and Clinical Neurosciences June 19, 2019
- KETAMINE'S MECHANISM OF ACTION: A PATH TO RAPID‐ACTING ANTIDEPRESSANTS Depression and Anxiety April 6, 2016
- Efficacy and Safety of Intranasal Esketamine in Patients With Treatment-Resistant Depression and Comorbid Chronic Post-traumatic Stress Disorder: Open-Label Single-Arm Pilot Study Frontiers in Psychiatry July 8, 2022
and 3 more in the library