Patient Experience with Intranasal Esketamine in Treatment-Resistant Depression: Insights from a Multicentric Italian Study (REAL-ESKperience)
Marco Di, M. Pepe, G. D’andrea, I. Marcelli, M. Pettorruso, I. Andriola, Stefano Barlati, Matteo Carminati, C. I. Cattaneo, Massimo Clerici, D. D. Berardis, S. Filippis, B. Dell'Osso, Giorgio Di Lorenzo, Giuseppe Maina, M. Manchia, M. Marcatili, V. Martiadis, C. Niolu, A. Petralia, Gianluca Rosso, G. Serafini, M. Signorelli, T. Vannucchi, M. Vismara, R. Zanardi, Antonio Vita, G. Sani, G. Martinotti, Real-Esk Study Group
Journal of Personalized Medicine April 1, 2025 DOI: 10.3390/jpm15040161 via Semantic Scholar
Summary
Most patients with treatment-resistant depression reported positive experiences with esketamine nasal spray. In a survey of 236 outpatients, 88.4% reported enhanced quality of life. Satisfaction levels varied: 10.2% were unsatisfied, 19.1% partially satisfied, 44.4% satisfied, and 26.3% very satisfied. The most satisfied patients noted early improvements in depressed mood, suicidal thoughts, and restlessness, and reported functional gains across all domains. Artificial intelligence analysis of open-ended responses identified themes of personal growth and a desire for tailored treatment settings. Integrating patient-reported experiences may help personalize care and improve adherence.
Study at a glance
| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 236 |
| Population | Outpatients with treatment-resistant depression treated with esketamine nasal spray for at least three months |
| Keywords | Medicine |
| Citations | 18 |
| Key finding | Most patients reported positive perceptions of esketamine nasal spray, with the most satisfied participants highlighting significant benefits to depressed mood, suicidal thoughts, and overall functioning. |
Abstract
Background. Treatment-resistant depression (TRD) is a prevalent, high-burden disorder. Esketamine nasal spray (ESK-NS) has been approved for, T.R.D.; and efficacy has been observed in both clinical trials and real-world studies. However, observations integrating patients’ perspective on this treatment are limited. This multicentric Italian study explored experiences with ESK-NS in TRD patients, focusing on perceived therapeutic effects and overall satisfaction. Methods. A self-report survey was administered to 236 outpatients with TRD (55.1% females, 54.1 ± 14.1 years) treated with ESK-NS for at least three consecutive months within standard clinical care. Based on satisfaction levels, participants were classified as “unsatisfied” (10.2%), “partially satisfied” (19.1%), “satisfied” (44.4%), or “very satisfied” (26.3%), and compared for sociodemographic, clinical characteristics, and feedback on perceived benefits. Artificial intelligence (OpenAI) served to categorize responses to an open-ended question. Results. Enhanced quality of life was reported by 88.4% of participants. Significant differences emerged in earliest self-perceived benefits, most relevant effects, and impact on global functioning across groups. Specifically, “very satisfied” patients described the following: early improvements in depressed mood, suicidal thoughts, and restlessness; decreased suicidal thoughts among the most significant effects; and functional gains across all domains. OpenAI identified experiences of personal growth and rediscovery and a desire for tailored settings and approaches as recurring topics. Conclusions. Most patients reported a positive perception of ESK-NS treatment. The most satisfied participants highlighted significant benefits to depressed mood, suicidal thoughts, and overall functioning. Patient-reported experiences offer insights into different psychopathological dimensions, including functional outcomes and quality of life. Integrating these perspectives into clinical practice might assist treatment personalization, improving patients’ adherence and satisfaction.