Repeated subcutaneous esketamine on treatment-resistant depression: An open-label dose titration study.

Autor: Palhano-Fontes F; Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., Cavalcanti-Ribeiro P; University Hospital Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Psychobiology Postgraduate Program, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil., da Costa Gonçalves KT; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., de Almeida VRN; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., Barbosa DC; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., de Araújo Ferreira MA; University Hospital Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil., Bolcont R; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., De Souza LCAM; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., Santos NC; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., Lopes EITC; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., de Medeiros Lima NB; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., de Brito AJC; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., Falchi-Carvalho M; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., Arcoverde E; University Hospital Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil., Araujo D; Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil., Galvão-Coelho NL; Psychobiology Postgraduate Program, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Center for Advanced Psychedelic Medicine, Natal, RN, Brazil. Electronic address: nicole.galvao@ufrn.br.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2025 Jan 15; Vol. 369, pp. 155-163. Date of Electronic Publication: 2024 Sep 26.
DOI: 10.1016/j.jad.2024.09.141
Abstrakt: Background: Ketamine has gained prominence as one of the most effective therapeutic options in unipolar treatment-resistant depression (TRD). However, most studies related to the antidepressant action of ketamine used intravenous (IV) or intranasal (IN) administration. The subcutaneous (SC) route of administration is a promising alternative, as it results in plasma levels comparable to IV, causes fewer side effects, and is easier and cheaper to administer than both IV and/or IN routes.
Methods: In this context, we conducted an open-label clinical trial for investigating the efficacy and safety of 8 weekly sessions of SC esketamine in TRD patients (n = 30).
Results: At the end of the treatment, a partial response rate of 26.09 %, a response rate of 52.17 % and remission rate of 34.78 % were observed, assessed by Montgomery-Åsberg Depression Rating Scale. Moreover, the self-reported depressive symptoms, as measured by the Beck Depression Inventory II (BDI-II), significantly decreased from the baseline to the final session, and the improvements were sustained throughout the week. Follow-up evaluations (BDI-II) up to the sixth month consistently showed scores lower than the baseline.
Limitations: The small sample size and the drop-out during the follow-up phase may limit the generalizability of the findings. Additionally, the absence of a control group necessitates cautious interpretation of causality.
Conclusions: This groundbreaking study, which addresses SC esketamine treatment for TRD, reported promising response and remission rates, as well as sustained antidepressant effects. It highlights the need for further research to improve and expand our knowledge of this innovative, more accessible, and cost-effective therapeutic approach.
Competing Interests: Declaration of competing interest The author(s) have no conflicts of interest to declare.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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