A six-month observational study of 36 patients with treatment-resistant depression found that those with poor mentalization abilities at the start had more severe depressive symptoms throughout treatment with esketamine. Greater cognitive rigidity appeared protective, possibly by stabilizing emotions and reducing negative thinking. The findings suggest esketamine may help break cognitive inflexibility and improve mentalization, supporting a personalized approach to treatment-resistant depression.
Intranasal Esketamine, when added to standard antidepressants, reduced depressive symptoms in three young adults with both treatment-resistant depression and autism spectrum disorder. Two patients achieved full remission and one showed partial remission over six months, with no major side effects. Suicidal thoughts decreased, but abilities related to understanding others' mental states improved only slightly. Quality of life scores rose substantially for all three patients. The authors note the small sample prevents statistical conclusions and call for larger, randomized studies.