Siegfried Kasper1, Wiesław J Cubała2, Andrea Fagiolini3, Josep A Ramos-Quiroga4,5,6,7, Daniel Souery8, Allan H Young9. 1. Center for Brain Research, Medical University of Vienna, Vienna, Austria. 2. Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland. 3. Department of Molecular Medicine, University of Siena, Siena, Italy. 4. Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain. 5. Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain. 6. Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain. 7. Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. 8. European Centre of Psychological Medicine, Psy Pluriel, Brussels, Belgium. 9. Department of Psychological Medicine, King's College London, London, UK.
Abstract
OBJECTIVES: Despite the available therapies for treatment-resistant depression (TRD), there are a limited number that are evidence-based and effective in this hard-to-treat population. Esketamine nasal spray, an intranasal N-methyl-d-aspartate (NMDA) glutamate receptor antagonist, is a novel, fast-acting option in this patient population. This manuscript provides expert guidance on the practicalities of using esketamine nasal spray. METHODS: A group of six European experts in major depressive disorder (MDD) and TRD, with clinical experience of treating patients with esketamine nasal spray, first generated practical recommendations, before editing and voting on these to develop consensus statements during an online meeting. RESULTS: The final consensus statements encompass not only pre-treatment considerations for patients with TRD, but also specific guidelines for clinicians to consider during and post-administration of esketamine nasal spray. CONCLUSIONS: Esketamine nasal spray is a novel, fast-acting agent that provides an additional treatment option for patients with TRD who have previously failed several therapies. The guidance here is based on the authors' experience and the available literature; however, further real-world use of esketamine nasal spray will add to existing knowledge. The recommendations offer practical guidance to clinicians who are unfamiliar with esketamine nasal spray.
OBJECTIVES: Despite the available therapies for treatment-resistant depression (TRD), there are a limited number that are evidence-based and effective in this hard-to-treat population. Esketamine nasal spray, an intranasal N-methyl-d-aspartate (NMDA) glutamate receptor antagonist, is a novel, fast-acting option in this patient population. This manuscript provides expert guidance on the practicalities of using esketamine nasal spray. METHODS: A group of six European experts in major depressive disorder (MDD) and TRD, with clinical experience of treating patients with esketamine nasal spray, first generated practical recommendations, before editing and voting on these to develop consensus statements during an online meeting. RESULTS: The final consensus statements encompass not only pre-treatment considerations for patients with TRD, but also specific guidelines for clinicians to consider during and post-administration of esketamine nasal spray. CONCLUSIONS: Esketamine nasal spray is a novel, fast-acting agent that provides an additional treatment option for patients with TRD who have previously failed several therapies. The guidance here is based on the authors' experience and the available literature; however, further real-world use of esketamine nasal spray will add to existing knowledge. The recommendations offer practical guidance to clinicians who are unfamiliar with esketamine nasal spray.
Authors: Anna Höflich; Christoph Kraus; Ruth M Pfeiffer; Rene Seiger; Dan Rujescu; Carlos A Zarate; Siegfried Kasper; Dietmar Winkler; Rupert Lanzenberger Journal: Transl Psychiatry Date: 2021-04-01 Impact factor: 6.222
Authors: Benjamin Spurny-Dworak; Godber Mathis Godbersen; Murray Bruce Reed; Jakob Unterholzner; Thomas Vanicek; Pia Baldinger-Melich; Andreas Hahn; Georg S Kranz; Wolfgang Bogner; Rupert Lanzenberger; Siegfried Kasper Journal: Front Mol Neurosci Date: 2022-07-13 Impact factor: 6.261
Authors: Jolien K E Veraart; Sanne Y Smith-Apeldoorn; Iris M Bakker; Berber A E Visser; Jeanine Kamphuis; Robert A Schoevers; Daan J Touw Journal: Int J Neuropsychopharmacol Date: 2021-10-23 Impact factor: 5.176