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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.

EV0828

Factors determining improvement in patients treated with esketamine

FACTORS DETERMINING THE IMPROVEMENT OF PATIENTS TREATED WITH ESKETAMINE

Response to esketamine treatment appears to be associated with prior antidepressant treatment having been optimized at the maximum dose, while none of the patients with comorbid dysthymic disorder responded.

The aim of the study was to identify factors determining adequate clinical improvement following esketamine treatment. This observational, descriptive study reported a 6-month follow-up of 40 patients, with depression severity assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS) at four time points (at treatment initiation, after the 4-week induction phase, during the maintenance phase from week 8 onward, and at the end of treatment). In the overall sample, the baseline MADRS score was 37.10 (severe), decreasing to 22.7 (moderate) at the end of treatment; among responders (n=20), the score decreased from 37.84 to 15.9 (mild), while among nonresponders (n=15), it changed from 35.2 to 30.1 (moderate). The most common secondary diagnoses were dysthymic disorders (10), personality disorders (8), and obsessive-compulsive disorders (2); personality disorders (8) were the most common in the responder group, whereas dysthymic disorders (10) were the most common in the nonresponder group. The most common concomitant antidepressant treatments were venlafaxine 300 mg (15), duloxetine (7), and desvenlafaxine (6); among responders, these were venlafaxine 300 mg (14) and clomipramine 75 mg (2). The most frequently used adjunctive treatments for depression were trazodone 100 mg (13), mirtazapine 30 mg (12), aripiprazole 5 mg (10), and cariprazine 3 mg (6); aripiprazole 5 mg (6) was reported among responders, while cariprazine 3 mg (3) and brexpiprazole (2) were reported among nonresponders. According to the authors, venlafaxine was part of the treatment regimen in most responders, and its combination with clomipramine yielded good results; augmentation with aripiprazole also appeared favorable. None of the patients with dysthymic disorder responded, whereas all patients with personality disorders responded, suggesting that personality disorder did not affect response. The fact that most responders had been receiving their prior antidepressant treatment at the maximum dose (most commonly venlafaxine 300 mg and aripiprazole 5 mg) highlights the importance of appropriate patient selection and optimization of prior treatment.

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