Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations.

Treatment-resistant depression (TRD) imposes severe burdens on patients, health services, and society, yet has lacked viable treatment options. An advisory panel of psychiatrists and clinical researchers experienced in managing TRD developed best practice statements on using esketamine nasal spray, one of the first TRD treatments licensed in 30 years. The panel agreed on recommendations for setting up and running an efficient esketamine clinic, emphasizing logistical planning, patient education to prevent discontinuation, and checklists for safe appointments. Expanding treatment options like esketamine nasal spray is likely key to improving long-term outcomes for this underserved population.

Study at a glance

Abstract

Treatment-resistant depression (TRD) is associated with profound morbidity for patients, placing a significant burden on those affected, the health service and wider society. Despite this, TRD remains chronically underserved in terms of viable treatment options. To address this gap, an advisory panel of psychiatrists and clinical researchers with experience in managing TRD convened to develop best practice statements on the use of esketamine nasal spray, one of the first TRD treatments to be licensed in 30 years. During a virtual meeting held on 12th November 2020, the advisory panel shared their experiences of using esketamine nasal spray in their clinical practice. The meeting focused on developing and refining recommendations for setting up and running an efficient esketamine nasal spray clinic for patients living with TRD. At the conclusion of the meeting, agreement was reached on all recommendation statements. In setting up an esketamine nasal spray clinic, it is important to consider the logistical requirements involved and put measures in place to ensure it runs as efficiently as possible. Educating patients about the treatment and maintaining their well-being is paramount for preventing discontinuation. Putting in place checklists can be a useful strategy for ensuring treatment appointments run smoothly and safely. Providing additional treatment options for the management of TRD, such as esketamine nasal spray, is likely to be key to improving the long-term outcomes of this underserved patient population.