Functional outcomes with esketamine in treatment-resistant depression: A 6-month multicenter real-world study.
European psychiatry : the journal of the Association of European Psychiatrists June 10, 2026 Riccardo Guglielmo, Miriam Olivola, Alberto Inuggi et al.
Over six months of routine esketamine treatment for treatment-resistant depression, depressive symptoms and daily functioning both improved progressively. By month six, 78.3% of patients showed a symptomatic response and 46.7% reached symptomatic remission, while 78.3% showed a functional response but only 33.3% achieved functional remission. Functional remission accumulated more slowly than symptomatic remission, with cumulative rates of 5% at one month, 15% at three months, and 33.3% at six months. Higher baseline disability and more previous antidepressant trials were linked to lower odds of functional remission at six months. The findings suggest that functional improvement follows a distinct trajectory from symptom improvement and should be monitored separately in treatment-resistant depression.