INTRANASAL ESKETAMINE AND MAOI COMBINATION IN THE MANAGEMENT OF TREATMENT-RESISTANT DEPRESSION: A CASE REPORT
Paulo Artur da Silva Rodrigues, Giovana Dos Santos Couto, Bárbara Corrêa Garcia Simões, Pablo Gnutzmann Pereira
Horizons of Insight: Exploring the Frontiers of Multidisciplinary Science March 31, 2026 DOI: 10.56238/sevened2026.008-239 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 27-year-old female patient with recurrent depressive disorder and treatment-resistant depression |
| Interventions | Intranasal esketamine Tranylcypromine |
| Measures | HAM-A, MADRS |
| Topics | Depression Esketamine |
| Key findings | The combination of intranasal esketamine and tranylcypromine led to rapid and sustained improvement in depressive and anxiety symptoms, with remission of suicidal ideation, and was well tolerated without relevant adverse events. |
Abstract
Introduction: Treatment-resistant depression (TRD) represents a significant clinical challenge, particularly when associated with suicidal ideation. Intranasal esketamine has emerged as an effective therapeutic option in refractory cases, while monoamine oxidase inhibitors (MAOIs) remain relevant in the management of severe and resistant conditions.
Objective: To describe the clinical course of a patient with TRD treated with the combination of intranasal esketamine and tranylcypromine.
Method: Case report of a 27-year-old female patient diagnosed with recurrent depressive disorder and a history of therapeutic failure to multiple classes of antidepressants, mood stabilizers, and antipsychotics, followed through clinical evaluation and standardized rating scales (HAM-A and MADRS).
Results: After initiation of the combined treatment, a rapid and sustained clinical improvement was observed, with significant reduction of depressive and anxiety symptoms, as well as remission of suicidal ideation. The treatment was well tolerated, with no relevant adverse events.
Conclusion: The association of intranasal esketamine and a MAOI proved to be effective and safe in this case of TRD, suggesting that it may represent a viable therapeutic alternative in selected situations, provided that strict clinical monitoring is ensured.
Comparable studies
Other case reports and case series on esketamine for depression, most cited first.