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Esketamine in Treatment Resistant Depression: The Way to Remission

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Detalhes bibliográficos
Resumo:Major depressive disorder affects an estimate of 5% of the population with nearly 1‑third of patients failing to achieve remission with conventional pharmacological treatment. Esketamine, a novel rapid‑acting antidepressant, with a noncompetitive antagonism on N‑methyl‑D‑Aspartate receptor, have been recently approved by Food and Drug Administration (FDA) and European Medicines Agency (EMA) for treatment‑resistant depression. Here, we report a clinical case of a 42‑year‑old Caucasian woman who endured many years with severe depressive symptoms and high functional impairment. Previous treatments included cognitive behavioral therapy, numerous pharmacological trials with antidepressants and augmentation agents, and neurostimulation approaches. Upon treatment with esketamine, the patient presented remarkable clinical recovery. Psychometric assessments determined an acute reduction on the MADRS score after 1 week and progressive recovery of the depressive symptoms on the following weeks. Likewise, PHQ‑9 scale assessments, evaluating the relative frequency of depressive symptoms. and the Sheehan scale, assessing functional recovery, also determined a pronounced symptomatic relief.
Autores principais:Facucho-Oliveira, João
Outros Autores:Esteves-Sousa, Daniel; Prates, Bruno; Neves, Rui; Varandas, Pedro
Assunto:Antidepressive Agents Depressive Disorder, Major/drug therapy Depressive Disorder, Treatment‑Resistant/ drug therapy Esketamine/administration & dosage Antidepressivos Escetamina Perturbação Depressiva Major/tratamento farmacológico Perturbação Depressiva Resistente a Tratamento/tratamento farmacológico
Ano:2021
País:Portugal
Tipo de documento:artigo
Tipo de acesso:unknown
Instituição associada:Sociedade Portuguesa de Psiquiatria e Saúde Mental
Idioma:inglês
Origem:Revista Portuguesa de Psiquiatria e Saúde Mental
Descrição
Resumo:Major depressive disorder affects an estimate of 5% of the population with nearly 1‑third of patients failing to achieve remission with conventional pharmacological treatment. Esketamine, a novel rapid‑acting antidepressant, with a noncompetitive antagonism on N‑methyl‑D‑Aspartate receptor, have been recently approved by Food and Drug Administration (FDA) and European Medicines Agency (EMA) for treatment‑resistant depression. Here, we report a clinical case of a 42‑year‑old Caucasian woman who endured many years with severe depressive symptoms and high functional impairment. Previous treatments included cognitive behavioral therapy, numerous pharmacological trials with antidepressants and augmentation agents, and neurostimulation approaches. Upon treatment with esketamine, the patient presented remarkable clinical recovery. Psychometric assessments determined an acute reduction on the MADRS score after 1 week and progressive recovery of the depressive symptoms on the following weeks. Likewise, PHQ‑9 scale assessments, evaluating the relative frequency of depressive symptoms. and the Sheehan scale, assessing functional recovery, also determined a pronounced symptomatic relief.