Intranasal esketamine plus oral antidepressant for treatment-resistant depression: acute induction and maintenance relapse-prevention outcomes in a systematic review and meta-analysis - Scorecard - MDSpire
Advertisement
Intranasal esketamine plus oral antidepressant for treatment-resistant depression: acute induction and maintenance relapse-prevention outcomes in a systematic review and meta-analysis
Clinical Scorecard: Combination of Intranasal Esketamine and Oral Antidepressant for Treatment-Resistant Depression: Outcomes of Acute Induction and Maintenance in a Systematic Review and Meta-Analysis
At a Glance
Category
Detail
Condition
Treatment-Resistant Depression (TRD)
Key Mechanisms
Glutamatergic modulation via NMDA receptor antagonism
Target Population
Patients with Major Depressive Disorder (MDD) who are treatment-resistant
Care Setting
Supervised clinical administration
Key Highlights
Intranasal esketamine plus oral antidepressant shows greater symptom reduction at day 28.
Rapid improvement in symptoms observed by day 2.
Esketamine reduces relapse risk during maintenance in stabilized responders/remitters.
Increased risk of treatment-emergent adverse events with esketamine in acute induction.
Notable increases in dissociation and blood pressure events.
Guideline-Based Recommendations
Diagnosis
Defined as nonresponse to at least two antidepressant trials of adequate dose and duration.
Management
Use of intranasal esketamine as an adjunct to oral antidepressants in TRD.
Monitoring & Follow-up
Post-dose monitoring required due to safety considerations.
Risks
Increased risk of dissociation, sedation, and blood pressure increases.
Patient & Prescribing Data
Adults with treatment-resistant major depressive disorder.
Esketamine provides rapid, modest acute improvement and reduces relapse risk.
Clinical Best Practices
Administer esketamine under supervised care.
Conduct individualized benefit-risk assessments for patients.
