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QUALITY OF LIFE AND PRODUCTIVITY AMONG ESKETAMINE RESPONDERS IN A REAL-WORLD STUDY IN AUSTRALIA AND NEW ZEALAND

Malcolm Hopwood, David Codyre, David Barton, Elizabeth Scott, Andrea Puig, Jarrad King, Ian B. Hickie

Journal of Psychiatric Research July 1, 2026 DOI: 10.1016/j.jpsychires.2026.07.011 (opens in new tab) via OpenAlex

Summary

AI-generated from the abstract

In a post-hoc subgroup analysis of an Early Access Program in Australia and New Zealand, 28 of 84 participants (33.3%) with treatment-resistant depression who received esketamine nasal spray plus a newly-initiated oral antidepressant over 16 weeks were classified as responders (≥50% decrease in HAMD-17 score). Responders showed mean improvements in depression severity (71.2%), quality of life (29.5% on AQoL-8D), and work productivity (≥11.9% on WPAI:SHP), with the largest gains in mental health (32.9%) and overall work productivity loss (35.9%). Results should be interpreted cautiously due to the post-hoc design, short follow-up, small sample, and missing data.

Study at a glance

Characteristics Post-hoc subgroup analysis of an Early Access Program Peer reviewed
Sample size 84
Population Patients with treatment-resistant depression in Australia and New Zealand
Intervention Esketamine nasal spray plus a newly-initiated oral antidepressant
Duration 16 weeks
Keywords Depression economics Mental health Productivity Rating scale Population
Key finding Among participants with treatment-resistant depression treated with esketamine plus an oral antidepressant, those classified as responders experienced concurrent improvements in depression symptoms, quality of life, and self-reported work productivity over 16 weeks.

Abstract

Treatment-resistant depression (TRD) is associated with severe depression, low quality of life (QoL) and reduced work productivity, which may increase risk of relapse, suicide and suboptimal response to treatment. Esketamine nasal spray plus a newly-initiated oral antidepressant (esketamine+OAD) has been shown to improve depression symptoms, QoL and productivity in patients with TRD; however real-world evidence is limited. This was a descriptive, exploratory post-hoc subgroup analysis of patients with TRD who received esketamine+OAD treatment over 16 weeks through an Early Access Program in Australia and New Zealand. This analysis aimed to describe response to esketamine+OAD (≥50% decrease in Hamilton Depression Rating Scale Index [HAMD-17] score at Week 16), including changes in depression severity, QoL and work productivity. QoL was assessed using the Assessment of QoL-8D (AQoL-8D) questionnaire and work productivity was assessed using the Workplace Productivity and Activity Impairment: Specific Health Problem Questionnaire (WPAI:SHP). Overall, 28 (33.3%) participants were identified as responders. Responders experienced mean improvements in HAMD-17 (71.2%), AQoL-8D (29.5%) and WPAI:SHP (≥11.9%) from Baseline to Week 16. The greatest improvement among AQoL-8D domains was observed in mental health (32.9%). The largest improvement in WPAI:SHP was seen in overall work productivity loss (35.9%). These findings describe concurrent improvements in symptoms, QoL and self-reported functioning among responders. Results should be interpreted with caution due to limitations conferred by the post-hoc design, short follow-up, small population sizes and missing data.

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