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.
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.