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.
Comparable studies
Other observational and cohort studies on esketamine for depression, most cited first.