Neurocognitive changes in a patient receiving esketamine for treatment-resistant depression.
JAAPA : official journal of the American Academy of Physician Assistants – September 01, 2024
Source: PubMed
Summary
A groundbreaking depression treatment showed unexpected effects on brain function in one patient. Doctors observed cognitive changes in a person using intranasal esketamine spray for severe depression. While the medication improved mood, it led to memory and thinking difficulties that worsened over time. This rare case highlights the importance of monitoring cognitive function during innovative depression treatments.
Abstract
Esketamine, the s(+) enantiomer of ketamine, was approved in 2019 as the first rapid-acting intranasal spray medication for treatment-resistant depression; the drug is given in combination with an antidepressant. The treatment is self-administered in a clinical setting under the supervision of a healthcare provider and usually is well tolerated. Many of its adverse reactions are mild, temporary, and dose-dependent, and they improve with subsequent treatments. Although the prescribing information lists difficulty remembering or thinking as possible adverse reactions, a neurocognitive evaluation is not part of the initial patient evaluation. This case report focuses on a patient whose neurocognitive symptoms worsened with esketamine treatment, necessitating treatment discontinuation.