Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated case
Introduction TRD is a highly disabling condition, often responsible for chronic clinical course, high number of relapses and elevated suicide risk. Intranasal esketamine is currently the only available pharmacological therapy specifically indicated for TRD, as add-on therapy to antidepressant treat...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822014316/type/journal_article |
| _version_ | 1797616849925439488 |
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| author | V. Martiadis F. Raffone R. Cerlino F. Mistico M. Russo |
| author_facet | V. Martiadis F. Raffone R. Cerlino F. Mistico M. Russo |
| author_sort | V. Martiadis |
| collection | DOAJ |
| description |
Introduction
TRD is a highly disabling condition, often responsible for chronic clinical course, high number of relapses and elevated suicide risk. Intranasal esketamine is currently the only available pharmacological therapy specifically indicated for TRD, as add-on therapy to antidepressant treatment with SSRI or SNRI.
Objectives
The purpose of the study was to evaluate the safety and efficacy of intranasal esketamine associated with CBT in a complex clinical case of TRD, over a six-month follow-up.
Methods
A 67-year-old patient with TRD was selected for treatment with intranasal esketamine+CBT as add-on to antidepressant therapy. Before each treatment session the HAM-D rating scale was administered. The patient underwent weekly CBT sessions throughout the 6 months follow-up. The effect on physical well-being and social functioning was evaluated by means of Short-Form-Health-Survey-36.
Results
After the first two administrations of intranasal esketamine the total score on HAM-D decreased by 10 units (from 26 to 16). After 6 weeks of treatment decreased from 26 to 12 with the disappearance of suicidal ideation present at T0. After 6 months the total HAM-D score decreased from 26 to 8. Treatment was well tolerated, with mild adverse effects, confined to the first two hours post-administration. In particular, mild sedation, dizziness, slight transient blood pressure rise were reported, never required medical intervention and resolved spontaneously during the observation period.
Conclusions
Intranasal esketamine add-on therapy + CBT was an effective and safe treatment allowing to achieve and maintain symptomatic remission in a complex case of TRD, improving quality of life, social functioning, and reducing suicidal ideation over a six-month follow-up.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:46:14Z |
| format | Article |
| id | doaj.art-617f850c997d4f41a7fa5eec0be9a342 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:46:14Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-617f850c997d4f41a7fa5eec0be9a3422023-11-17T05:07:30ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S559S55910.1192/j.eurpsy.2022.1431Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated caseV. Martiadis0F. Raffone1R. Cerlino2F. Mistico3M. Russo4ASL Napoli 1 Centro, Department Of Mental Health, Napoli, ItalyASL Napoli 1 Centro, Department Of Mental Health, Napoli, ItalyASL Napoli 1 Centro, Department Of Mental Health, Napoli, ItalyASL Napoli 1 Centro, Department Of Mental Health, Napoli, ItalyASL Napoli 1 Centro, Department Of Mental Health, Napoli, Italy Introduction TRD is a highly disabling condition, often responsible for chronic clinical course, high number of relapses and elevated suicide risk. Intranasal esketamine is currently the only available pharmacological therapy specifically indicated for TRD, as add-on therapy to antidepressant treatment with SSRI or SNRI. Objectives The purpose of the study was to evaluate the safety and efficacy of intranasal esketamine associated with CBT in a complex clinical case of TRD, over a six-month follow-up. Methods A 67-year-old patient with TRD was selected for treatment with intranasal esketamine+CBT as add-on to antidepressant therapy. Before each treatment session the HAM-D rating scale was administered. The patient underwent weekly CBT sessions throughout the 6 months follow-up. The effect on physical well-being and social functioning was evaluated by means of Short-Form-Health-Survey-36. Results After the first two administrations of intranasal esketamine the total score on HAM-D decreased by 10 units (from 26 to 16). After 6 weeks of treatment decreased from 26 to 12 with the disappearance of suicidal ideation present at T0. After 6 months the total HAM-D score decreased from 26 to 8. Treatment was well tolerated, with mild adverse effects, confined to the first two hours post-administration. In particular, mild sedation, dizziness, slight transient blood pressure rise were reported, never required medical intervention and resolved spontaneously during the observation period. Conclusions Intranasal esketamine add-on therapy + CBT was an effective and safe treatment allowing to achieve and maintain symptomatic remission in a complex case of TRD, improving quality of life, social functioning, and reducing suicidal ideation over a six-month follow-up. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822014316/type/journal_articleesketaminetreatment resistant depressionCBTQuality of Life |
| spellingShingle | V. Martiadis F. Raffone R. Cerlino F. Mistico M. Russo Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated case European Psychiatry esketamine treatment resistant depression CBT Quality of Life |
| title | Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated case |
| title_full | Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated case |
| title_fullStr | Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated case |
| title_full_unstemmed | Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated case |
| title_short | Intranasal Esketamine + CBT: a 6 months follow-up of a resistant depression complicated case |
| title_sort | intranasal esketamine cbt a 6 months follow up of a resistant depression complicated case |
| topic | esketamine treatment resistant depression CBT Quality of Life |
| url | https://www.cambridge.org/core/product/identifier/S0924933822014316/type/journal_article |
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