Journal of Personalized Medicine
April 1, 2025
Marco Di, M. Pepe, G. D’andrea et al.
18 citations
Most patients with treatment-resistant depression reported positive experiences with esketamine nasal spray. In a survey of 236 outpatients, 88.4% reported enhanced quality of life. Satisfaction levels varied: 10.2% were unsatisfied, 19.1% partially satisfied, 44.4% satisfied, and 26.3% very satisfied. The most satisfied patients noted early improvements in depressed mood, suicidal thoughts, and restlessness, and reported functional gains across all domains. Artificial intelligence analysis of open-ended responses identified themes of personal growth and a desire for tailored treatment settings. Integrating patient-reported experiences may help personalize care and improve adherence.
Psychiatry Research
July 26, 2025
G. D’andrea, C. Cavallotto, M. Pettorruso et al.
16 citations
Anhedonia, the reduced ability to experience pleasure, is a core symptom of both unipolar and bipolar depression that often responds poorly to standard antidepressants. In a real-world observational study of 253 treatment-resistant patients (199 with unipolar depression, 54 with bipolar depression), repeated doses of esketamine nasal spray added to ongoing medication significantly reduced anhedonia over three months. The effect was distinct from overall mood improvement. At three months, 51.92% of bipolar and 38% of unipolar patients showed at least a 50% reduction in anhedonia scores. Dropout rates were low (around 13–14%), and manic switches were rare. The findings suggest esketamine has a targeted, transdiagnostic anti-anhedonic effect.
Journal of Affective Disorders
September 1, 2025
M. Olivola, Filippo Mazzoni, Barbara Tarantino et al.
8 citations
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.
Acta Psychiatrica Scandinavica
September 8, 2023
G. D’andrea, M. Pettorruso, T. Rhee et al.
8 citations
Treatment-resistant depression (TRD) often requires rapid symptom relief. Intravenous ketamine (KET-IV) and intranasal esketamine (ESK-NS) are glutamatergic agents that show rapid antidepressant effects, with KET-IV acting faster and ESK-NS providing long-term maintenance. The authors propose a "ketamine/esketamine bridge therapy" for further testing, modeled on a strategy from internal medicine: KET-IV would induce rapid effects, then patients would transition to ESK-NS for sustained benefit. This approach aims to address the limited accessibility of intravenous ketamine and leverage the scalability of the intranasal formulation, potentially benefiting patients with acute depression or suicidal ideation.