Esketamine Nasal Spray: Rapid Relief for TRD and Suicide Prevention—Mechanisms and Pharmacodynamics DOI Creative Commons
Hui Song,

Yang Luo,

Lingzhi Fang

et al.

Neuropsychiatric Disease and Treatment, Journal Year: 2024, Volume and Issue: Volume 20, P. 2059 - 2071

Published: Nov. 1, 2024

Esketamine nasal spray has emerged as a promising rapid-relief therapy for treatment-resistant depression (TRD) and suicide prevention. This review examines the chemical structure pharmacodynamics of esketamine, highlighting its primary action on NMDA receptors additional effects AMPA receptors, opioid monoaminergic inflammatory pathways. Despite synergistic mechanisms contributing to clinical benefits not being fully understood, future studies are essential refine our understanding optimize use. Clinical research indicates that esketamine effectively alleviates depressive symptoms prevents suicidal behavior in TRD patients, demonstrating good safety efficacy over extended periods. Specifically, multiple randomized controlled trials have shown reduces within hours maintains these several weeks, with favorable profile minimal side observed long-term The approval significant implications healthcare practices policies, offering new therapeutic option addresses urgent needs patients severe depression.

Language: Английский

Improvements in functioning and workplace productivity with esketamine nasal spray versus quetiapine extended release in patients with treatment resistant depression: Findings from a 32-week randomised, open-label, rater-blinded phase IIIb study DOI Creative Commons
Eduard Vieta,

Nahida Ahmed,

Celso Arango

et al.

European Neuropsychopharmacology, Journal Year: 2025, Volume and Issue: 93, P. 29 - 39

Published: Feb. 8, 2025

Patients with treatment resistant depression (TRD) experience a greater negative impact on their functioning and productivity at home in the workplace versus treatment-responsive patients. Here, we report effects of esketamine nasal spray (NS) quetiapine extended release (XR) functioning, work activity impairment. ESCAPE‑TRD (NCT04338321) was 32-week randomised, open‑label, rater‑blinded, active‑controlled phase IIIb study comparing efficacy safety NS XR, both alongside an ongoing selective serotonin reuptake inhibitor or norepinephrine (SSRI/SNRI), patients TRD. Patient assessed via Sheehan Disability Scale (SDS; functional remission ≤6). Absenteeism, presenteeism, loss impairment over time were using Work Productivity Activity Impairment: Depression (WPAI:D) questionnaire. Results cumulated entire duration. Esketamine NS-treated (N = 336) experienced 43.2 % more weeks XR-treated 340) period (difference: 2.0 [95 CI: 0.7, 3.3]; p 0.0023 [ANCOVA models]). Up to Week 32, 11.9 reduction due absenteeism -1.1 -2.9, 0.7]; 0.2285) 14.2 overall -2.3 weeks, 95 [-3.9, -0.7] 0.0045) patients, based mixed models for repeated measures. receiving improvements 32 XR. These demonstrate clinical benefit

Language: Английский

Citations

2
Six Years After Approval of Esketamine Nasal Spray for Serious Depression: Clinical Conundrums and Unanswered Questions DOI
Sanjay J. Mathew, Nicholas Murphy

American Journal of Psychiatry, Journal Year: 2025, Volume and Issue: 182(3), P. 227 - 230

Published: March 1, 2025

Language: Английский

Citations

1
Association between major cardiovascular events and esketamine: A disproportionality analysis in the WHO pharmacovigilance database DOI
Tanguy Taillefer de Laportalière, Mark Horowitz, Thomas Soeiro

et al.

European Neuropsychopharmacology, Journal Year: 2025, Volume and Issue: 96, P. 12 - 14

Published: April 16, 2025

Language: Английский

Citations

0
The effects of ketamine and esketamine on measures of quality of life in major and treatment-resistant depression: A systematic review DOI Creative Commons

M Cheng,

Christine E Dri,

Hana Ballum

et al.

Journal of Affective Disorders, Journal Year: 2025, Volume and Issue: 382, P. 438 - 442

Published: April 22, 2025

Language: Английский

Citations

0
Treatment-resistant depression and intranasal esketamine: Spanish clinical consensus on practical aspects DOI Creative Commons
Josep Antoni Ramos‐Quiroga, Fernando Mora, Silvia Arostegui

et al.

The European Journal of Psychiatry, Journal Year: 2025, Volume and Issue: 39(3), P. 100313 - 100313

Published: May 2, 2025

Language: Английский

Citations

0
Psychedelika und Dissoziativa in der Psychiatrie: Herausforderungen in der Behandlung DOI Creative Commons
Johannes Jungwirth, Francesco Bavato, Boris B. Quednow

et al.

Der Nervenarzt, Journal Year: 2024, Volume and Issue: 95(9), P. 803 - 810

Published: Aug. 28, 2024

With the discovery of antidepressive effects ketamine and increasing withdrawal pharmaceutical industry from development new psychotropic drugs, psychiatric research into clinical application hallucinogens in psychiatry has literally blossomed last two decades. Promising results for various treatment approaches with psychedelic agents, such lysergic acid diethylamide (LSD) psilocybin, dissociative as esketamine, have raised great hopes among researchers, clinicians patients recent years, so that there was already talk a era psychiatry. As one first these substances, December 2019 intranasal esketamine approved USA EU treatment-resistant depression Switzerland followed 2020. Recently, psilocybin Australia, Canada compassionate use exceptional cases depression, while large approval studies agents are currently ongoing worldwide. The medical ketamine/esketamine is considered to be safe; however, all forms it crucial importance that, addition hopes, specific challenges must also carefully assessed. Excessive expectations an insufficient risk-benefit estimation detrimental reputation treating physician. Although possible paradigm shift care mental health being discussed, this review article consciously concentrates on risks methodological weaknesses carried out far.

Language: Английский

Citations

1
Psychiatric first-aid kit: A review of EMA's critical medicines list DOI
Eduard Vieta,

Lídia Ilzarbe

European Neuropsychopharmacology, Journal Year: 2024, Volume and Issue: 89, P. 26 - 27

Published: Sept. 26, 2024

Language: Английский

Citations

1
Esketamine Nasal Spray: Rapid Relief for TRD and Suicide Prevention—Mechanisms and Pharmacodynamics DOI Creative Commons
Hui Song,

Yang Luo,

Lingzhi Fang

et al.

Neuropsychiatric Disease and Treatment, Journal Year: 2024, Volume and Issue: Volume 20, P. 2059 - 2071

Published: Nov. 1, 2024

Esketamine nasal spray has emerged as a promising rapid-relief therapy for treatment-resistant depression (TRD) and suicide prevention. This review examines the chemical structure pharmacodynamics of esketamine, highlighting its primary action on NMDA receptors additional effects AMPA receptors, opioid monoaminergic inflammatory pathways. Despite synergistic mechanisms contributing to clinical benefits not being fully understood, future studies are essential refine our understanding optimize use. Clinical research indicates that esketamine effectively alleviates depressive symptoms prevents suicidal behavior in TRD patients, demonstrating good safety efficacy over extended periods. Specifically, multiple randomized controlled trials have shown reduces within hours maintains these several weeks, with favorable profile minimal side observed long-term The approval significant implications healthcare practices policies, offering new therapeutic option addresses urgent needs patients severe depression.

Language: Английский

Citations

1