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Esketamine: new hope for the treatment of treatment-resistant depression? A narrative review
Citation
Salahudeen, MS and Wright, CM and Peterson, GM, Esketamine: new hope for the treatment of treatment-resistant depression? A narrative review, Therapeutic Advances in Drug Safety, 11 pp. 71-93. ISSN 2042-0986 (2020) [Refereed Article]
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Copyright Statement
Copyright The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
DOI: doi:10.1177/2042098620937899
Abstract
This narrative review aims to provide an overview of the current literature on the
pharmacology, safety, efficacy and tolerability of intranasal esketamine, the S-enantiomer
of ketamine, for the treatment of treatment-resistant depression (TRD). A literature search
using Medline, Embase, PsycINFO and Cochrane Central was conducted (January 2000 to
July 2019). Product information and www.clinicaltrials.gov were also reviewed. The literature
search was limited to human studies published in English. PhaseI, II, and III studies of
intranasal esketamine for TRD were reviewed. About a third of patients with major depressive
disorder fail to achieve remission despite treatment with multiple antidepressants. This
article examines the trials that led to the approval of esketamine in the United States, as
well as other recent studies of esketamine for TRD. The findings from limited phaseIII trials
illustrate that intranasal esketamine is effective and safe in reducing depressive symptoms
and achieving clinical response in patients with TRD. The optimum duration and frequency of
use are not fully understood. Although the nasal spray is a convenient dosage form, its use in
practice may be limited by cost and administrative regulation. While it may prove beneficial
to many patients who suffer from TRD, further long-term data are required, along with
comparative trials with the R-isomer (arketamine). In the interim, care and monitoring should
be exercised in its use in clinical practice.
Item Details
| Item Type: | Refereed Article |
|---|---|
| Keywords: | antidepressant, esketamine, intranasal, major depressive disorder, R-ketamine, S-ketamine, TRD, treatment resistant depression |
| Research Division: | Biomedical and Clinical Sciences |
| Research Group: | Pharmacology and pharmaceutical sciences |
| Research Field: | Clinical pharmacology and therapeutics |
| Objective Division: | Health |
| Objective Group: | Public health (excl. specific population health) |
| Objective Field: | Mental health |
| UTAS Author: | Salahudeen, MS (Dr Mohammed Salahudeen) |
| UTAS Author: | Wright, CM (Mr Cameron Wright) |
| UTAS Author: | Peterson, GM (Professor Gregory Peterson) |
| ID Code: | 140092 |
| Year Published: | 2020 |
| Web of Science® Times Cited: | 17 |
| Deposited By: | Pharmacy |
| Deposited On: | 2020-07-27 |
| Last Modified: | 2021-05-27 |
| Downloads: | 20 View Download Statistics |
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