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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0814

Intranasal esketamine in treatment-resistant depression: effectiveness in complex patients and predictors of response in real-world clinical practice

INTRANASAL ESKETAMINE IN TREATMENT-RESISTANT DEPRESSION: EFFECTIVENESS IN COMPLEX PATIENTS AND PREDICTORS OF RESPONSE IN REAL-WORLD CLINICAL PRACTICE

In real-world settings, intranasal esketamine also provided clinically meaningful improvement in complex patients with treatment-resistant depression who had psychiatric comorbidities or a history of suicide attempts.

The aim of the study was to evaluate the real-world effectiveness of intranasal esketamine (IN ESK) in treatment-resistant depression (TRD) and to examine clinical factors associated with treatment response, including suicidality, psychiatric comorbidity, prior pharmacological treatment burden, and dissociative symptoms. A retrospective observational study was conducted involving the first 60 patients with TRD treated with intranasal esketamine in routine clinical practice in Palma (Spain). Depressive symptoms were assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS), and pretreatment dissociative symptoms were assessed using the Dissociative Experiences Scale (DES). Response was defined as a reduction of at least 50% in the baseline MADRS score, and remission as a MADRS score below 12. The mean age of the sample was 51.8 (11.8) years, and 61.7% were women (n=37); 15 patients had a history of suicide attempts, and 38 had psychiatric comorbidities. During the current episode, 70.0% of patients had received psychotherapy and 30% had received electroconvulsive therapy (ECT); the mean baseline DES score was 32.4 (12.2). In the overall sample, the MADRS score was 33.9 (7.8) at baseline, 22.2 (8.4) at month 1, 18.1 (7.9) at month 3, and 15.7 (9.6) at month 6. At month 6, 38.3% of patients met the response criteria and 15.7% achieved remission; response and remission rates did not differ significantly according to psychiatric comorbidity or history of suicide attempts (all p>0.05). Neither baseline DES scores nor the occurrence of dissociative symptoms during sessions was significantly associated with treatment response; 50.0% of patients reported dissociative experiences in more than 50% of sessions. The most common adverse effects were dizziness (58.3%), headache (20.0%), nausea/vomiting (16.7%), and hypertension (8.3%). The authors state that the findings indicate meaningful improvement in clinically complex patients with TRD, but that larger prospective studies are needed to confirm them.

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