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A promising nasal spray treatment is offering hope to individuals struggling with treatment-resistant depression (TRD), a particularly challenging form of the condition that persists despite conventional medication. This innovative approach shows potential for addressing this global mental health issue.

Esketamine nasal spray can treat TRD

Champalimaud Foundation’s Neuropsychiatry Unit head and the study’s coordinator in Portugal said is characterized by ongoing depressive symptoms even after trying two different antidepressant medications.

Addressing Treatment-Resistant Depression (TRD) poses a notable challenge. Information obtained from the National Institute of Mental Health (NIMH) suggests that although approximately 33% of individuals suffering from depression experience relief with their first treatment, only 10-15% achieve relief after undergoing three treatment cycles. As a result, there is a growing demand for more efficacious treatment alternatives.

Lately, there has been substantial excitement within the healthcare sector regarding esketamine nasal spray, a product created by Janssen. It has demonstrated superior efficacy compared to a placebo in multiple clinical studies and has obtained endorsement from both the US FDA and the European Medicines Agency (EMA).

Esketamine growing in popularity

Oliveira-Maia says that the enthusiasm surrounding esketamine is due to the limited drug options for treatment-resistant depression. However, Oliveira-Maia warns that drug manufacturers must prove its superiority over existing treatments to gain widespread acceptance by clinicians, patients, and healthcare providers.

In a comparative study, researchers evaluated the effectiveness of esketamine and quetiapine XR, originally designed for conditions like schizophrenia but now authorized for treating challenging cases of depression. Oliveira-Maia notes that quetiapine XR is one of the limited alternative medications endorsed as an augmentation therapy for patients with major depressive episodes who do not respond adequately to standard antidepressant treatment.

The study, spanning 32 weeks, allowed the assessment of long-term and short-term treatment outcomes with continuous monitoring of participants’ responses, side effects, and medication efficacy conducted during this period.

In an eight-week study, 27.1% of the participants in the esketamine group reached a symptom-free state (remission), whereas 17.6% in the quetiapine XR group achieved the same. By the end of the 32-week study, of those who attained remission by week 8, 21.7% in the esketamine group maintained it.