The Patient’s Perspective on the Effects of Intranasal Esketamine in Treatment-Resistant Depression

This open-label prospective study (n=25) evaluated esketamine nasal spray (ESK-NS) treatment for treatment-resistant depression (TRD). Over three months, patients reported early and sustained improvements in depression, anhedonia, and suicidality, while clinicians detected improvements that varied at different time points.

Abstract of The Patient’s Perspective on the Effects of Intranasal Esketamine in Treatment-Resistant Depression

“The effectiveness of the esketamine nasal spray (ESK-NS) for treatment-resistant depression (TRD) has been confirmed by real-world studies. Available evidence derived from clinician-rated assessments might differ from patients’ perceptions about the helpfulness of treatments. We aimed to verify the effect of ESK-NS from patients’ view in 25 TRD patients (56% males, 55.1 ± 10.9 years) treated with ESK-NS (mean dose: 78.4 ± 11.43 mg) for three months and evaluated at different time-points through clinician-rated and self-administered scales, assessing changes in depression, anhedonia, sleep, cognition, suicidality, and anxiety. We observed an overall early improvement that lasted over time (endpoint total score reduction in Montgomery-Åsberg Depression Rating Scale, p < 0.001, Beck Depression Inventory, p = 0.003). Patients reported a significant self-rated decrease in anhedonia at two months (Snaith–Hamilton Pleasure Scale, p = 0.04) and in suicide ideation at endpoint (BDI subitem 9, p = 0.039) vs. earlier improvements detected by clinicians (one-month reduction in MADRS subitem 8, p = 0.005, and subitem 10, p = 0.007). These findings confirm the effectiveness of a three-month treatment with ESK-NS in TRD patients, highlighting an overall overlapping response from patients’ and clinicians’ perspectives, although with some differential effects on specific symptoms at given time-points. Including patients’ viewpoints in routine assessments could inform clinical practice, ensuring a better characterization of clinical phenotypes to deliver personalized interventions.”

Authors: Maria Pepe, Giovanni Bartolucci, Ilaria Marcelli, Francesco Pesaresi, Andrea Brugnami, Romina Caso, Alessia Fischetti, Flavia Grisoni, Marianna Mazza, Giovanni Camardese, Marco Di Nicola & Gabriele Sani

Summary of The Patient’s Perspective on the Effects of Intranasal Esketamine in Treatment-Resistant Depression