Repeated oral esketamine in patients with treatment resistant depression and comorbid posttraumatic stress disorder
Jolien K. E. Veraart, M. van Westenbrugge, J.E. van Wulfften Palthe, Annemarie van der Meij, Robert A. Schoevers, Joop T. V. M. de Jong
Heliyon May 1, 2023 DOI: 10.1016/j.heliyon.2023.e15883 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 5 |
| Population | Patients with treatment-resistant depression and comorbid PTSD |
| Intervention | Esketamine |
| Duration | Six weeks to a year |
| Topics | Depression Esketamine |
| Citations | 30 |
| Key findings | In four of five patients with treatment-resistant depression and comorbid PTSD, repeated oral esketamine was associated with improved depressive symptoms, increased resilience, and greater receptiveness to psychotherapy; one patient's symptoms worsened after a threatening situation during treatment. The authors propose that esketamine within a psychotherapeutic framework is promising and call for controlled trials. |
Abstract
Introduction: Ketamine and its S-enantiomer esketamine are novel pharmacotherapeutic options for treatment resistant depression (TRD). There is growing evidence on the efficacy for other psychiatric disorders, including posttraumatic stress disorder (PTSD). It is hypothesized that psychotherapy may further potentiate the effects of (es)ketamine in psychiatric disorders.
Methods: Repeated oral esketamine was prescribed once or twice weekly in five patients suffering from TRD and comorbid PTSD. We describe the clinical effects of esketamine and report data from psychometric instruments and patients' perspectives.
Results: Esketamine treatment duration ranged from six weeks to a year. In four patients, we observed improvement in depressive symptoms, increased resilience and more receptiveness to psychotherapy. One patient experienced symptom worsening in response to a threatening situation during esketamine treatment, highlighting the need for a safe setting.
Discussion: (Es)ketamine treatment within a psychotherapeutic framework appears promising in patients with treatment resistant symptoms of depression and PTSD. Controlled trials are warranted to validate these results and to elucidate the optimal treatment methods.