Advances in therapy
May 1, 2025
Patricio Molero, Angela Ibañez, Javier de Diego-Adeliño et al.
8 citations
In a real-world Spanish study of 189 adults with treatment-resistant depression, esketamine nasal spray led to response or remission in 80.4% of patients during the induction phase and 90% during the maintenance phase. Remission rates rose from 9.5% in induction to 38.3% in maintenance. Over a quarter of patients (28.0%) reported symptom improvement within 24 hours. Most adverse events were mild and decreased over time, especially in the first four weeks. The findings suggest esketamine nasal spray is an effective and safe option for treatment-resistant depression.
Journal of psychopharmacology (Oxford, England)
January 1, 2025
Luis Gutiérrez-Rojas, Julia Vendrell-Serres, J Antoni Ramos-Quiroga et al.
8 citations
Intranasal esketamine, combined with an antidepressant, significantly reduced depressive symptoms in patients with severe treatment-resistant depression. In a retrospective study of 71 patients (70% women, 85% with work disability), Montgomery-Asberg depression rating scale scores dropped from a mean baseline of 38.27 at 28, 90, and 180 days. Side effects were common but mostly mild and temporary. Patients who also received psychotherapy had lower depression scores at 90 and 180 days than those who did not. The authors argue that pharmacological treatment for treatment-resistant depression should be integrated with psychotherapy, social support, and family interventions to optimize outcomes.
Journal of affective disorders
January 28, 2026
Clara De Oliveira Lapa, Thiago Viola, Rodrigo Delfino et al.
3 citations
Intranasal esketamine substantially reduces depressive symptoms and increases remission rates over time in patients with treatment-resistant depression treated in routine clinical practice. A meta-analysis of nine observational studies found a large effect size (Hedges' g = -1.98) and that patients were about five times more likely to achieve remission at three months compared with the induction phase (odds ratio = 5.1). Treatment effectiveness was not influenced by gender or the presence of anxiety, personality, or substance use disorders. Any adverse event occurred in 82% of patients, most commonly dissociation (49%). The findings support esketamine's effectiveness and tolerability in real-world settings, though the observational design and lack of control groups warrant cautious interpretation.