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Esketamine for treatment of depression in Huntington's disease: A case report

Carsten Saft, Julia Jessen, David Kiefner, Georg Juckel

Journal of Huntington s Disease September 17, 2026 DOI: 10.1177/18796397261489245 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population A 60-year-old male with Huntington's disease and treatment-resistant depression
Intervention Esketamine
Duration Three treatment days, with a three-month follow-up
Measures Beck Depression Inventory (BDI)
Topics Depression Esketamine
Key findings Nasal esketamine was followed by a rapid mood improvement in a man with Huntington's disease and 20-year treatment-resistant depression, with his Beck Depression Inventory score dropping from 29 to 5 after three treatment days, though depression worsened again by three months (BDI 20). The authors suggest esketamine may be a treatment option for psychiatric symptoms in HD.

Abstract

Depression and suicidal ideation are common in Huntington's disease (HD). We report a 60-year-old male with HD who suffered from treatment-resistant depression with intermittent suicidal thoughts for 20 years, irritability and apathy. Despite multiple trials of antidepressants, no sustained improvement was achieved. Under nasal esketamine treatment his mood improved dramatically after three treatment days. Beck Depression Inventory (BDI) score dropped from 29 to 5. In a three-month follow-up investigation depression worsened again (BDI score: 20). To our knowledge, this is the first reported case of esketamine use in HD, suggesting that esketamine may be a treatment option for psychiatric symptoms in HD, particularly treatment-resistant depression.

In the evidence

This study is part of the evidence base for 3 syntheses in the library. Here is how each one recorded it.

  • Nasal esketamine was followed by rapid mood improvement (BDI 29 to 5 after three days), but depression worsened again by three months (BDI 20).

    Synthesized

  • Nasal esketamine was followed by rapid mood improvement (BDI 29 to 5 after three days), but depression worsened again by three months (BDI 20).

    Synthesized

  • Nasal esketamine was followed by rapid mood improvement (BDI 29 to 5 after three treatment days), but depression worsened again by three months (BDI 20).

    Synthesized

Comparable studies

Other case reports and case series on esketamine for depression, most cited first.

Study Year Design Participants
Electroconvulsive Therapy, Ketamine, and Esketamine in a Patient with Major Depressive Disorder and Multiple Comorbidities: A Case Report over 10-year Treatment from Adolescence to Adulthood. A patient with treatment-resistant depression and comorbid generalized anxiety... 2025 Case report n = 1
Effects of intranasal (S)-ketamine on Veterans with co-morbid treatment-resistant depression and PTSD: A retrospective case series Veterans with co-morbid depression and PTSD 2022 Retrospective case series n = 35
Case report: Intramuscular ketamine or intranasal esketamine as a treatment in four patients with major depressive disorder and comorbid anorexia nervosa Patients with anorexia nervosa and a comorbid depressive disorder treated at a private... 2023 Case report n = 4
Repeated oral esketamine in patients with treatment resistant depression and comorbid posttraumatic stress disorder Patients with treatment-resistant depression and comorbid PTSD 2023 Case series n = 5
Disembodiment and Affective Resonances in Esketamine Treatment of Depersonalized Depression Subtype: Two Case Studies. Patients with treatment resistant depression and depersonalized depression symptoms 2024 Case study n = 2

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