Case report: Intranasal esketamine for severe major depressive disorder with psychotic features
IntroductionAbout one third of patients with major depressive disorder (MDD) have treatment resistant depression (TRD). The difficulty of treating TRD especially in those with suicidal ideation and psychotic features demands treatments that are fast-acting, safe, and effective. Limited access, lack...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-07-01
|
| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.937996/full |
| _version_ | 1818189092259627008 |
|---|---|
| author | Maximilian Carter Kassandra Solsrud Nicholas Mischel |
| author_facet | Maximilian Carter Kassandra Solsrud Nicholas Mischel |
| author_sort | Maximilian Carter |
| collection | DOAJ |
| description | IntroductionAbout one third of patients with major depressive disorder (MDD) have treatment resistant depression (TRD). The difficulty of treating TRD especially in those with suicidal ideation and psychotic features demands treatments that are fast-acting, safe, and effective. Limited access, lack of viable options, and incomplete characterization of rapid-acting antidepressants has prevented widespread incorporation into treatment of patients with TRD. However, ketamine and its variations have shown promise of being effective treatment options for patients with TRD with psychotic features.Case descriptionThis 28-year-old patient with TRD with psychotic features received 14 treatments of intranasal esketamine over a 3-month period. This patient initially presented with anhedonia, difficulty sleeping, suicidal thoughts, and auditory hallucinations. The Quick Inventory of Depressive Symptomology (QIDS) was used to assess depression before each session.ResultsAfter her first two treatment sessions within a week, this patient experienced a reduction in depression from severe to moderate according to the QIDS. Over 14 sessions, she had no significant adverse effects, including no psychotic symptoms during esketamine treatment, and was stabilized to mild depression without suicidal ideations. One year after treatment, she continues to be stable. She has not had auditory hallucinations since the esketamine treatment.ConclusionsThis case report provides an example of a patient with severe TRD with psychotic features that showed significant improvement after treatment with intranasal esketamine. Larger studies are indicated to further elucidate the effectiveness and safety of intranasal esketamine, so it can be more widely used for patients with TRD with psychotic features. |
| first_indexed | 2024-12-11T23:37:19Z |
| format | Article |
| id | doaj.art-d2499a61a11d426fa09b39fa28f011fd |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-11T23:37:19Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-d2499a61a11d426fa09b39fa28f011fd2022-12-22T00:45:51ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-07-011310.3389/fpsyt.2022.937996937996Case report: Intranasal esketamine for severe major depressive disorder with psychotic featuresMaximilian CarterKassandra SolsrudNicholas MischelIntroductionAbout one third of patients with major depressive disorder (MDD) have treatment resistant depression (TRD). The difficulty of treating TRD especially in those with suicidal ideation and psychotic features demands treatments that are fast-acting, safe, and effective. Limited access, lack of viable options, and incomplete characterization of rapid-acting antidepressants has prevented widespread incorporation into treatment of patients with TRD. However, ketamine and its variations have shown promise of being effective treatment options for patients with TRD with psychotic features.Case descriptionThis 28-year-old patient with TRD with psychotic features received 14 treatments of intranasal esketamine over a 3-month period. This patient initially presented with anhedonia, difficulty sleeping, suicidal thoughts, and auditory hallucinations. The Quick Inventory of Depressive Symptomology (QIDS) was used to assess depression before each session.ResultsAfter her first two treatment sessions within a week, this patient experienced a reduction in depression from severe to moderate according to the QIDS. Over 14 sessions, she had no significant adverse effects, including no psychotic symptoms during esketamine treatment, and was stabilized to mild depression without suicidal ideations. One year after treatment, she continues to be stable. She has not had auditory hallucinations since the esketamine treatment.ConclusionsThis case report provides an example of a patient with severe TRD with psychotic features that showed significant improvement after treatment with intranasal esketamine. Larger studies are indicated to further elucidate the effectiveness and safety of intranasal esketamine, so it can be more widely used for patients with TRD with psychotic features.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.937996/fullesketaminedepressionpsychoticcase reportintranasal |
| spellingShingle | Maximilian Carter Kassandra Solsrud Nicholas Mischel Case report: Intranasal esketamine for severe major depressive disorder with psychotic features Frontiers in Psychiatry esketamine depression psychotic case report intranasal |
| title | Case report: Intranasal esketamine for severe major depressive disorder with psychotic features |
| title_full | Case report: Intranasal esketamine for severe major depressive disorder with psychotic features |
| title_fullStr | Case report: Intranasal esketamine for severe major depressive disorder with psychotic features |
| title_full_unstemmed | Case report: Intranasal esketamine for severe major depressive disorder with psychotic features |
| title_short | Case report: Intranasal esketamine for severe major depressive disorder with psychotic features |
| title_sort | case report intranasal esketamine for severe major depressive disorder with psychotic features |
| topic | esketamine depression psychotic case report intranasal |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.937996/full |
| work_keys_str_mv | AT maximiliancarter casereportintranasalesketamineforseveremajordepressivedisorderwithpsychoticfeatures AT kassandrasolsrud casereportintranasalesketamineforseveremajordepressivedisorderwithpsychoticfeatures AT nicholasmischel casereportintranasalesketamineforseveremajordepressivedisorderwithpsychoticfeatures |