Efficacy and Safety of Intranasal Esketamine in Treatment-Resistant Depression in Adults: A Systematic Review
Cureus August 21, 2021 Alisha Sapkota, Hajra Khurshid, Israa A Qureshi et al. 44 citations
Intranasal esketamine, approved by the FDA in 2019 for treatment-resistant depression in adults, shows some efficacy in reducing depressive symptoms, but the clinical meaningfulness of the effect in real-world populations remains unclear. A systematic review of 10 studies found that only one of three short-term clinical trials demonstrated a statistically significant difference between esketamine plus an oral antidepressant versus placebo plus an oral antidepressant. The relapse prevention study showed significantly delayed relapse of depressive symptoms with esketamine, and a long-term trial found sustained improvement. Common adverse effects included nausea, dizziness, dissociation, headache, vertigo, somnolence, and dysgeusia, mostly mild to moderate. Rare serious side effects such as panic attacks, mania, and self-harm ideation have been reported, warranting further investigation.