Esketamine in Treatment Resistant Depression: The Way to Remission
João Facucho-Oliveira, Daniel Esteves-Sousa, Bruno Prates, Rui Neves, Pedro Varandas
Revista Portuguesa de Psiquiatria e Saúde Mental March 5, 2021 DOI: 10.51338/rppsm.2021.v.i1.174 (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 42-year-old Caucasian woman with severe treatment-resistant major depressive disorder and high functional impairment |
| Intervention | Esketamine |
| Measures | MADRS, PHQ-9, Sheehan scale |
| Topics | Depression Esketamine |
| Key findings | In this single case, a 42-year-old woman with severe treatment-resistant depression experienced marked clinical recovery after esketamine treatment, with an acute reduction in MADRS score at one week, progressive improvement in depressive symptoms over following weeks, and pronounced symptomatic and functional relief on the PHQ-9 and Sheehan scales. |
Abstract
Major depressive disorder affects an estimate of 5% of the population with nearly 1‑third of patients failing to achieve remission with conventional pharmacological treatment. Esketamine, a novel rapid‑acting antidepressant, with a noncompetitive antagonism on N‑methyl‑D‑Aspartate receptor, have been recently approved by Food and Drug Administration (FDA) and European Medicines Agency (EMA) for treatment‑resistant depression. Here, we report a clinical case of a 42‑year‑old Caucasian woman who endured many years with severe depressive symptoms and high functional impairment. Previous treatments included cognitive behavioral therapy, numerous pharmacological trials with antidepressants and augmentation agents, and neurostimulation approaches. Upon treatment with esketamine, the patient presented remarkable clinical recovery. Psychometric assessments determined an acute reduction on the MADRS score after 1 week and progressive recovery of the depressive symptoms on the following weeks. Likewise, PHQ‑9 scale assessments, evaluating the relative frequency of depressive symptoms. and the Sheehan scale, assessing functional recovery, also determined a pronounced symptomatic relief.
Comparable studies
Other case reports and case series on esketamine for depression, most cited first.
Citations in the library
Cites 5
- Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study American Journal of Psychiatry May 21, 2019
- Efficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Patients With Treatment-Resistant Depression JAMA Psychiatry June 5, 2019
- Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression JAMA Psychiatry December 27, 2017
- Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study American Journal of Psychiatry April 16, 2018
- Esketamine for Treatment-Resistant Depression - First FDA-Approved Antidepressant in a New Class. New England Journal of Medicine May 22, 2019