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Long-term remission following esketamine nasal spray sessions in a patient with severe and highly treatment-resistant depression: a single-case report.

Lucas Arrighi, Eloïse Maakaron, Théo Korchia, Christophe Lançon, Raphaëlle Richieri

International Clinical Psychopharmacology July 11, 2023 DOI: 10.1097/yic.0000000000000482 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population 31-year-old female inpatient with severe, chronic, multiresistant treatment-resistant major depressive disorder
Intervention Intranasal esketamine
Dose 84 mg
Duration 20 bi-weekly sessions; maintenance phase and 1-year follow-up
Topics Depression Ketamine Esketamine
Keywords Humans Antidepressive agents Treatment outcome Remission induction Administration, intranasal Adult Female Nasal sprays Depressive disorder, treatment-resistant
Key findings A 31-year-old woman with severe, chronic treatment-resistant depression who had failed 14 antidepressants and several neurostimulation techniques achieved remission after an acute course of intranasal esketamine (84 mg) over 20 bi-weekly sessions, with no significant adverse effects. She remained stable through the maintenance phase and one year later, suggesting intranasal esketamine may be an effective and safe option in multiresistant depression.

Abstract

About 30% of patients with major depressive disorder have treatment-resistant depression (TRD). Recently, intranasal esketamine was approved as a treatment option after the failure of two antidepressant trials. We report a patient with multiresistant depression that was successfully and safely treated with esketamine nasal spray. This 31-year-old inpatient with severe, chronic, and multi-TRD received an acute course of intranasal esketamine (84 mg). Previously, 14 different antidepressants, alone or in potentiation, and several neurostimulation techniques had been unsuccessful. Over 20 bi-weekly sessions, she had no significant adverse effects and was stabilized into remission. During the maintenance phase and 1 year after, she continues to be stable. This case report provides an example of a patient with severe TRD that showed significant improvement after treatment with intranasal esketamine.

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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