The Patient’s Perspective on the Effects of Intranasal Esketamine in Treatment-Resistant Depression
Maria Pepe, Giovanni Bartolucci, Ilaria Marcelli, Francesco Pesaresi, Andrea Brugnami, Romina Caso, Alessia Fischetti, Flavia Grisoni, Marianna Mazza, Giovanni Camardese, Marco di Nicola, Gabriele Sani
Brain Sciences October 22, 2023 DOI: 10.3390/brainsci13101494 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 25 |
| Population | Adults with treatment-resistant depression (56% male, mean age 55.1 years) |
| Intervention | Esketamine nasal spray |
| Dose | mean dose: 78.4 ± 11.43 mg |
| Duration | Three months |
| Measures | Montgomery-Åsberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), Snaith–Hamilton Pleasure Scale |
| Topics | Depression Esketamine |
| Citations | 27 |
| Key findings | Three months of esketamine nasal spray in treatment-resistant depression produced early improvement that persisted, with significant reductions in clinician-rated and self-rated depression scores. Patients reported significant decreases in anhedonia at two months and suicidal ideation at endpoint, while clinicians detected earlier improvements in specific MADRS items at one month, suggesting partially differential symptom trajectories across perspectives. |
Abstract
The effectiveness of the esketamine nasal spray (ESK-NS) for treatment-resistant depression (TRD) has been confirmed by real-world studies. Available evidence derived from clinician-rated assessments might differ from patients’ perceptions about the helpfulness of treatments. We aimed to verify the effect of ESK-NS from patients’ view in 25 TRD patients (56% males, 55.1 ± 10.9 years) treated with ESK-NS (mean dose: 78.4 ± 11.43 mg) for three months and evaluated at different time-points through clinician-rated and self-administered scales, assessing changes in depression, anhedonia, sleep, cognition, suicidality, and anxiety. We observed an overall early improvement that lasted over time (endpoint total score reduction in Montgomery-Åsberg Depression Rating Scale, p < 0.001, Beck Depression Inventory, p = 0.003). Patients reported a significant self-rated decrease in anhedonia at two months (Snaith–Hamilton Pleasure Scale, p = 0.04) and in suicide ideation at endpoint (BDI subitem 9, p = 0.039) vs. earlier improvements detected by clinicians (one-month reduction in MADRS subitem 8, p = 0.005, and subitem 10, p = 0.007). These findings confirm the effectiveness of a three-month treatment with ESK-NS in TRD patients, highlighting an overall overlapping response from patients’ and clinicians’ perspectives, although with some differential effects on specific symptoms at given time-points. Including patients’ viewpoints in routine assessments could inform clinical practice, ensuring a better characterization of clinical phenotypes to deliver personalized interventions.
Comparable studies
Other observational and cohort studies on esketamine, most cited first.
Citations in the library
Cited by 14
- Ketamine treatment for anhedonia in unipolar and bipolar depression: a systematic review. European Neuropsychopharmacology September 1, 2024
- Patient Experience with Intranasal Esketamine in Treatment-Resistant Depression: Insights from a Multicentric Italian Study (REAL-ESKperience) Journal of Personalized Medicine April 1, 2025
- Intranasal esketamine for patients with major depressive disorder: A systematic review and meta-analysis. Journal of Psychiatric Research December 1, 2024
- A Multi-Center, Open-Label, Single-Arm Study to Investigate the Early Effectiveness of Esketamine Nasal Spray in Patients with Treatment-Resistant Depression Using a Mobile Self-Monitoring Application. Pharmaceuticals August 30, 2024
- Heart Rate Variability as a Potential Predictor of Response to Intranasal Esketamine in Patients with Treatment-Resistant Depression: A Preliminary Report. Journal of Clinical Medicine August 14, 2024
and 9 more in the library
Cites 20
- 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
- Synthesizing the Evidence for Ketamine and Esketamine in Treatment-Resistant Depression: An International Expert Opinion on the Available Evidence and Implementation American Journal of Psychiatry March 17, 2021
- Ketamine modulates fronto-striatal circuitry in depressed and healthy individuals Molecular Psychiatry September 14, 2020
- Treating bipolar depression with esketamine: Safety and effectiveness data from a naturalistic multicentric study on esketamine in bipolar versus unipolar treatment‐resistant depression Bipolar Disorders January 13, 2023
- Predicting outcome with Intranasal Esketamine treatment: A machine-learning, three-month study in Treatment-Resistant Depression (ESK-LEARNING) Psychiatry Research July 29, 2023
and 15 more in the library