2026-04-13T18:29:06Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/122082025-10-24T10:35:13Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:35:13Z urn:hdl:11351/12208 Treating Treatment-resistant Depression with Esketamine Nasal Spray When All Therapeutic Options Have Been Exhausted: Clinical Experience from a Spanish Cohort of Expanded Use Vendrell Serres, Júlia Soto-Angona, Óscar Rodriguez-Urrutia, Amanda Inzoli, Benedetta LÓPEZ, Antonia Ramos-Quiroga, Josep Antoni Avaluació de resultats (Assistència sanitària) Depressió psíquica - Tractament Antidepressius - Ús terapèutic CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Central Nervous System Agents::Psychotropic Drugs::Antidepressive Agents PSYCHIATRY AND PSYCHOLOGY::Mental Disorders::Mood Disorders::Depressive Disorder::Depressive Disorder, Treatment-Resistant PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Behavior::Behavioral Symptoms::Depression Other subheadings::Other subheadings::Other subheadings::/drug therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::fármacos del sistema nervioso central::fármacos psicotrópicos::antidepresivos PSIQUIATRÍA Y PSICOLOGÍA::trastornos mentales::trastornos del humor::trastorno depresivo::trastorno depresivo resistente al tratamiento PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::conducta::síntomas conductuales::depresión Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento Depressive disorder; Esketamine; Treatment-resistant Trastorno depresivo; Esketamina; Resistente al tratamiento Trastorn depressiu; Esketamina; Resistent al tractament Objective: Treatment Resistant Depression (TRD) is commonly defined as the lack of response to two or more anti-depressants with different mechanisms of action. Up to 30% of patients diagnosed with major depressive disorder might be considered to present TRD. The objective of this study was to assess the effectiveness and tolerability of esketamine in patients diagnosed with TRD, who were referred to our program after exhausting all available treatments. A secondary objective consisted in researching the relationship between response and previous use of electroconvulsive therapy. Methods: A prospective, observational study was carried out in patients enrolled in the expanded use of esketamine in our center. They received esketamine prior to its marketing authorisation, for therapeutic purposes. Sixteen subjects were analyzed. Effectiveness was assessed with the Montgomery-Asberg depression rating scale (MADRS). Patients were followed up to 4 months after the administration. Results: Esketamine showed a rapid, robust effect in improving depressive symptoms, with no specific correlation between outcome and any demographic or clinical traits evaluated. No differences were found between patients that previously received Electroconvulsive Therapy, and those that didn’t. 10 out of 16 patients responded (＞ 50% change in baseline MADRS scores), but only five achieved remission (＜ 12 points in the global MADRS score). We provide some recommendations, based on clinical experience, to improve tolerability and adherence, and to manage adverse effects. Conclusion: Results suggest that esketamine is a safe, effective and rapid-acting option for TRD. More studies are needed to properly assess predictors of response outcome. 2025-10-24T10:35:13Z 2025-10-24T10:35:13Z 2024-11-11T11:00:37Z 2024-11-11T11:00:37Z 2024 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/12208 Clinical Psychopharmacology and Neuroscience;22(1) https://doi.org/10.9758/cpn.23.1097 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess Korean College of Neuropsychopharmacology Scientia