Intranasal esketamine for treatment-resistant depression: real-world effectiveness in electroconvulsive therapy non-responders
The European Journal of Psychiatry March 7, 2026 Rocío Gómez-juanes, Guillermo Mompaler Lázaro, Adoración Castro et al. 1 citation
Intranasal esketamine is a newer treatment for Treatment-Resistant Depression (TRD), but its long-term benefits in real-world settings remain uncertain. A 6-month observational study of 60 highly chronic and complex TRD patients (average episode length 41.2 months, 61.6% with psychiatric comorbidity) found that depression scores (MADRS) dropped from an average of 33.9 at baseline to 15.7 at 6 months. Patients who had not responded to prior electroconvulsive therapy (ECT) showed no significant difference in therapeutic response compared to those who had not tried ECT. The findings suggest that intranasal esketamine may be worth testing promptly in TRD patients who have not responded to ECT.