Département de psychiatrie d'urgence et de soins post-aigus, Centre hospitalo-universitaire de Montpellier, IGF, Université de Montpellier, CNRS, Inserm, Montpellier, France.
2 papers in the library · 1 citation · publishing 2025-2026
In a retrospective study of 22 adults with treatment-resistant depression and comorbid post-traumatic stress disorder who received esketamine nasal spray, trauma re-experiencing episodes occurred during treatment sessions. For 16 patients (72.7%) these episodes disappeared as sessions progressed. Treatment was stopped for 6 patients (27.3%) due to re-experiencing. Among those who continued esketamine, depression response rate was 45.5% and remission 22.7%; PTSD improvement rate was 45.5% and remission 18.2%. The findings suggest esketamine can be safely administered in this comorbid population and that trauma re-experiencing does not prevent clinical improvement.
Suicidal thoughts and behaviors form a distinct dimension that cuts across psychiatric diagnoses, supported by genetic, biomarker, and preclinical evidence. Key endophenotypes include impulsivity, anhedonia, and hopelessness, with emerging mechanisms in inflammation, stress response, serotonin function, and neuroplasticity. Treatments like lithium and ketamine target these pathways. The French Minds cohort within the PEPR PROPSY project will use multimodal approaches to identify biological signatures and trajectories of this dimension.