Esketamine nasal spray for treatment-resistant depression: A retrospective multicenter real-world cohort study on effectiveness and suicidal outcomes.
Journal of psychopharmacology (Oxford, England) March 21, 2026 J García-jiménez, D Nuñez-arias, G Carretero Merelo et al.
In a real-world clinical setting across three Spanish centers, esketamine nasal spray produced progressive improvements in depressive symptoms and functioning in adults with treatment-resistant depression. Among 50 patients, significant reductions in depression severity and disability were observed at every assessment from week 2 through discharge, with notable gains during weeks 8–16. The median time to response was 8 weeks, and to remission 16 weeks; overall response and remission rates reached 70% and 68%. Suicidal risk shifted early toward lower categories, with no suicide attempts during treatment. Higher refractoriness, measured by the Maudsley Staging Model, independently predicted lower odds of response and remission.