Pharmaceutics
December 22, 2023
Ludivine Boudieu, Myriam Mennetrier, Pierre-Michel Llorca et al.
22 citations
Intranasal ketamine and esketamine offer a rapid onset of antidepressant effects within hours for people with major depressive disorder, particularly those with treatment-resistant depression or active suicidal thoughts. A systematic review following PRISMA guidelines found stronger evidence of efficacy for intranasal esketamine than for intranasal ketamine. The safety profile of intranasal esketamine appears acceptable, though further studies are needed; a more accurate delivery device is required for ketamine. These glutamatergic agents bypass the blood–brain barrier, potentially reducing side effects compared with intravenous administration.
Depression and anxiety
January 1, 2024
Ludovic Samalin, Lila Mekaoui, Maud Rothärmel et al.
16 citations
In a French real-world study of 157 patients with treatment-resistant depression who began esketamine nasal spray, most discontinued treatment within about 19 weeks. After one month, 40% of those still on the drug showed clinical response and 20% achieved remission. Adverse events occurred in 69% of patients, with serious events in 17%. The findings align with earlier clinical trials, confirming esketamine's role in treating treatment-resistant depression.
International journal of psychiatry in clinical practice
June 1, 2024
Ludovic Samalin, Lila Mekaoui, Pierre De Maricourt et al.
3 citations
An observational study of adults with treatment-resistant depression (TRD) treated with esketamine across three time periods found that patients had moderate-to-severe depression, with an average Montgomery-Åsberg Depression Rating Scale score of 32.6. The 157 treated patients (average age 49.0 years, 66.2% female) showed varied disease severity, subtypes, and comorbidities across cohorts. Later cohorts used esketamine earlier and before other treatments. The findings indicate a high burden of TRD and suggest esketamine is a potentially useful alternative, especially as clinicians gain more familiarity and access.
European journal of psychotraumatology
December 1, 2026
Maud Rothärmel, Lila Mekaoui, François Kazour et al.
1 citation
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.
Journal of psychiatric research
June 1, 2026
Ludovic Samalin, Maud Rothärmel, Lila Mekaoui et al.
In patients with treatment-resistant depression, depressive symptoms improved rapidly during the first four weeks of intranasal esketamine treatment. Among 128 patients in a French real-world study, the average depression rating score fell by 7.5 points after one week and by 13.5 points after four weeks. The proportion of patients whose score dropped by at least half rose from 19.4% at week 1 to 47.4% at week 4. Experiencing dissociation during the first week was linked to a threefold higher chance of response at week 1, but no other factors predicted response. The findings suggest early dissociation may play a role in treatment response, but more research is needed on prognostic factors.