Intranasal esketamine for ECT-refractory bipolar depression: a case report
Muhammad Abbas, Bruno Kallas, Max Garris
Frontiers in Psychiatry July 30, 2026 DOI: 10.3389/fpsyt.2026.1890002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 52-year-old female with ECT-refractory bipolar depression |
| Intervention | Esketamine nasal spray |
| Topics | Depression Esketamine |
| Key findings | Esketamine nasal spray improved depressive symptoms in a patient with ECT-refractory bipolar depression, with relapse after dose reduction and improvement upon resuming the induction regimen; no manic or hypomanic events were reported. |
Abstract
This is a case report of a 52 year old female with ECT-refractory bipolar depression who was treated with esketamine nasal spray, leading to a noticeable improvement in her depressive symptoms. She experienced a relapse after a reduction in her maintenance treatment in conjunction with psychosocial stressors, but improved once again after returning to her induction regimen. She tolerated the treatment well with minimal side effects and no reported manic or hypomanic events. More robust research is warranted to better characterize the effectiveness of esketamine in treating treatment-resistant bipolar depression.
Comparable studies
Other case reports and case series on esketamine for depression, most cited first.
Citations in the library
Cites 12
- Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study American Journal of Psychiatry April 16, 2018
- Esketamine Nasal Spray Plus Oral Antidepressant in Patients With Treatment-Resistant Depression The Journal of Clinical Psychiatry April 20, 2020
- Treating bipolar depression with esketamine: Safety and effectiveness data from a naturalistic multicentric study on esketamine in bipolar versus unipolar treatment‐resistant depression Bipolar Disorders January 13, 2023
- The Role of Ketamine in the Treatment of Bipolar Depression: A Scoping Review. Brain Sciences June 4, 2023
- Real‐world effectiveness of repeated ketamine infusions for treatment‐resistant bipolar depression Bipolar Disorders December 14, 2022
and 7 more in the library