Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review
Esketamine (ESK) has been approved as a rapid-acting intranasal treatment for treatment-resistant depression (TRD). Although existing studies have investigated the efficacy of ESK in the 4-week induction phase, our knowledge about long-term ESK efficacy remains poor. The aim of this systematic revie...
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MDPI AG
2021-08-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/22/17/9338 |
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| author | Enrico Capuzzi Alice Caldiroli Martina Capellazzi Ilaria Tagliabue Matteo Marcatili Fabrizia Colmegna Massimo Clerici Massimiliano Buoli Antonios Dakanalis |
| author_facet | Enrico Capuzzi Alice Caldiroli Martina Capellazzi Ilaria Tagliabue Matteo Marcatili Fabrizia Colmegna Massimo Clerici Massimiliano Buoli Antonios Dakanalis |
| author_sort | Enrico Capuzzi |
| collection | DOAJ |
| description | Esketamine (ESK) has been approved as a rapid-acting intranasal treatment for treatment-resistant depression (TRD). Although existing studies have investigated the efficacy of ESK in the 4-week induction phase, our knowledge about long-term ESK efficacy remains poor. The aim of this systematic review was to summarize the available data on long-term ESK efficacy for TRD. A systematic search was performed including articles in English, up to 31 March 2021. The search found 7 relevant studies, involving 1024 adult TRD patients. Continuing treatment with ESK after the 4-week induction phase may be associated with stable efficacy in relapse prevention among TRD patients. Conversely, the long-term antidepressant effectiveness upon discontinuation of ESK might be limited, although data from three studies had a moderate to high risk of bias. Overall, the results on the effectiveness of this compound in the long term are mixed. According to our findings, ESK treatment should be continued following the induction phase to reach a stable efficacy in relapse prevention, while the long-term antidepressant and anti-suicidal effects of ESK after discontinuation are inconsistent. Currently, the level of proof of ESK efficacy in long-term TRD treatment remains low and more RCTs with larger sample sizes and active comparators are needed. |
| first_indexed | 2024-03-10T08:10:31Z |
| format | Article |
| id | doaj.art-3094baee4a4d484a96ea7069516a74a8 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-10T08:10:31Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-3094baee4a4d484a96ea7069516a74a82023-11-22T10:41:51ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672021-08-012217933810.3390/ijms22179338Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic ReviewEnrico Capuzzi0Alice Caldiroli1Martina Capellazzi2Ilaria Tagliabue3Matteo Marcatili4Fabrizia Colmegna5Massimo Clerici6Massimiliano Buoli7Antonios Dakanalis8Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, ItalyPsychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, ItalyDepartment of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, ItalyDepartment of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, ItalyPsychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, ItalyPsychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, ItalyPsychiatric Department, Azienda Socio Sanitaria Territoriale Monza, via G.B. Pergolesi 33, 20900 Monza, ItalyDepartment of Pathophysiology and Transplantation, University of Milan, via Festa del Perdono 7, 20122 Milan, ItalyDepartment of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza, ItalyEsketamine (ESK) has been approved as a rapid-acting intranasal treatment for treatment-resistant depression (TRD). Although existing studies have investigated the efficacy of ESK in the 4-week induction phase, our knowledge about long-term ESK efficacy remains poor. The aim of this systematic review was to summarize the available data on long-term ESK efficacy for TRD. A systematic search was performed including articles in English, up to 31 March 2021. The search found 7 relevant studies, involving 1024 adult TRD patients. Continuing treatment with ESK after the 4-week induction phase may be associated with stable efficacy in relapse prevention among TRD patients. Conversely, the long-term antidepressant effectiveness upon discontinuation of ESK might be limited, although data from three studies had a moderate to high risk of bias. Overall, the results on the effectiveness of this compound in the long term are mixed. According to our findings, ESK treatment should be continued following the induction phase to reach a stable efficacy in relapse prevention, while the long-term antidepressant and anti-suicidal effects of ESK after discontinuation are inconsistent. Currently, the level of proof of ESK efficacy in long-term TRD treatment remains low and more RCTs with larger sample sizes and active comparators are needed.https://www.mdpi.com/1422-0067/22/17/9338treatment-resistant depressionesketamineclinical trialscontinuationsystematic review |
| spellingShingle | Enrico Capuzzi Alice Caldiroli Martina Capellazzi Ilaria Tagliabue Matteo Marcatili Fabrizia Colmegna Massimo Clerici Massimiliano Buoli Antonios Dakanalis Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review International Journal of Molecular Sciences treatment-resistant depression esketamine clinical trials continuation systematic review |
| title | Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review |
| title_full | Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review |
| title_fullStr | Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review |
| title_full_unstemmed | Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review |
| title_short | Long-Term Efficacy of Intranasal Esketamine in Treatment-Resistant Major Depression: A Systematic Review |
| title_sort | long term efficacy of intranasal esketamine in treatment resistant major depression a systematic review |
| topic | treatment-resistant depression esketamine clinical trials continuation systematic review |
| url | https://www.mdpi.com/1422-0067/22/17/9338 |
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