The Journal of clinical psychiatry
October 2, 2024
Mia C Santucci, Mina Ansari, Sina Nikayin et al.
12 citations
In a real-world clinical setting, 45 patients with treatment-resistant bipolar depression received intravenous ketamine or intranasal esketamine. Among 38 who completed an acute series (twice-weekly treatments for up to four weeks), 39% achieved a clinical response (at least 50% improvement on the Montgomery-Asberg Depression Rating Scale) and 13.2% achieved remission (score of 10 or lower). Mean depression scores dropped from 31.1 to 19.2, a 38.3% improvement. No manic or hypomanic episodes occurred during the acute phase. However, during maintenance treatment, 28.9% of patients experienced hypomanic or manic symptoms, with one severe event requiring hospitalization.
Journal of affective disorders
July 15, 2025
Mina Ansari, Taeho Greg Rhee, Mia C Santucci et al.
4 citations
Patients with obesity were significantly more likely to respond to intranasal esketamine for treatment-resistant depression than non-obese patients. Among 190 patients treated at a single clinic, 34.2% were obese. Obese patients had a 63% higher chance of achieving at least a 50% improvement on the Montgomery-Åsberg Depression Rating Scale compared to non-obese patients. However, when BMI was analyzed as a continuous measure, no linear relationship with treatment response was found. The authors suggest that increased body fat may prolong the presence of lipid-soluble esketamine or its metabolites, but the underlying mechanisms remain unknown.
The Journal of clinical psychiatry
May 4, 2026
Samuel T Wilkinson, Brandon M Kitay, Matthew Macaluso et al.
Adding cognitive behavioral therapy to esketamine treatment reduces suicidal ideation more than esketamine alone in people with major depression and suicidal thoughts. In a randomized trial of 93 patients, 72% completed the study, meeting feasibility goals. Those who received 16 weeks of CBT plus esketamine showed greater improvement on three measures of suicidal ideation than those receiving esketamine with usual care: a mean difference of -1.91 on the Beck Scale for Suicidal Ideation, -0.33 on the Clinician Global Improvement Scale for Suicide Severity, and -3.77 on the depression rating scale. No difference was found on the Columbia-Suicide Severity Rating Scale or in suicide-related events.