Intranasal Esketamine for Treating Inpatients with Borderline Personality Disorder and Comorbid Treatment-Resistant Depression – a Retrospective Chart Review Study
Hannah Tramontano, Jeffrey Fetter, Mohamed Wagdy ElSayed
preprint DOI: 10.20944/preprints202501.0316.v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective chart review |
|---|---|
| Sample size | 10 |
| Population | Inpatients with borderline personality disorder and comorbid major depressive disorder, including treatment-resistant depression, admitted to a rural state psychiatric hospital |
| Intervention | Esketamine |
| Topics | Depression Esketamine |
| Key findings | Among 10 inpatients with borderline personality disorder and treatment-resistant depression, seven reported improved mood and seven denied suicidal ideation after starting intranasal esketamine, but these changes were not statistically significant. A non-significant increase in impulsive behavior was also observed, though episodes were shorter than before treatment. The authors conclude further studies are needed to evaluate esketamine's efficacy in this population. |
Abstract
Background: Borderline Personality Disorder (BPD) affects 1.35% of the population and is frequently comorbid with Major Depressive Disorder (MDD), which is frequently treatment-resistant (TRD). Patients with comorbid illness have worse treatment outcomes and functional impairment. Esketamine could ameliorate symptoms of both illnesses.
Methods: We conducted a retrospective chart review of inpatients with BPD and MDD admitted to a state psychiatric hospital in a rural NH state who received intranasal esketamine.
Results: 10 patients were admitted and received esketamine. Seven patients reported an increase in positive mood states (p = 1), and seven patients denied suicidal ideations after starting treatment (p = 0.22). We also noticed a statistically non-significant increase in impulsive behavior following the start of esketamine treatment (p = 0.611). The duration of these behaviors was shorter compared to patients’ pre-esketamine behaviors (p = 0.612).
Conclusion: Further studies are needed to evaluate the efficacy of esketamine in treating patients with BPD and comorbid TRD.