Psychiatria pre prax 2/2024

Escape from hard-to-treat depression with esketamine

Although remission is the principal goal of treatment for depression, remission occurs in a substantially low proportion of patients who have had the needed more consecutive treatments. There is an urgent need for effective and tailored treatment for treatment-resistant depression. In clinical practice, pharmacological treatments approved for the treatment of major depressive disorder, including oral antidepressants and augmentation medications, are used in a variety of treatment strategies and combinations. The newly published data brought clinically relevant outcomes comparing esketamine nasal spray with quetiapine extended-release, a commonly used, recommended antipsychotic augmentation agent, in combination with a continued SSRI or SNRI during the initial and maintenance phases of treatment in patients with treatment-resistant depression. Existing guidelines for the treatment of patients with treatment-resistant depression are not consistent; these data collectively support the use of esketamine nasal spray for treatment-resistant depression.

Keywords: antidepressants, esketamine, quetiapine, depression, treatment-resistant depression, hard-to-treat depression