In a six-month naturalistic study of 62 patients with treatment-resistant depression and high suicide risk, those receiving intranasal esketamine showed faster and greater reductions in suicidal thoughts and depressive symptoms compared to those receiving alternative pharmacological treatments. The number needed to treat to prevent one case of high suicide risk was 1.35. Functional improvement was similar between groups. The findings support esketamine as a rapid-acting option in real-world, closely monitored care.
In three young adults (ages 20–25) with mild to moderate autism spectrum disorder and treatment-resistant depression, intranasal esketamine added to standard antidepressants reduced depressive symptoms. Two patients achieved clinical remission at six months, and one showed partial response. Suicidal ideation decreased, but mentalization and social cognition improved only mildly. Subjective quality of life rose substantially for all three. No major side effects occurred. These preliminary observations require confirmation in controlled trials.