Paradoxical Depressive Response to Intranasal Esketamine in Treatment-Resistant Depression: A Case Series.
The American journal of case reports December 28, 2024 Jose A Ontiveros-Sánchez de la Barquera, Luis Alberto De La Garza García, Silvia Viridiana Esquivel García et al. 2 citations
Two patients with treatment-resistant depression initially improved with intranasal esketamine but then experienced rapid worsening of depressive symptoms and suicidal ideation. After stopping esketamine, both patients clinically improved and their suicidal thoughts diminished. The cause of this paradoxical reaction is unclear, but the report highlights that such adverse responses can occur even when treatment initially appears effective. Clinicians should be aware of this potential complication.