Reducing esketamine's adverse effects with oral antidepressant pairings

The Journal of Clinical PsychiatryScott Cunningham MD PhD, et al. | September 20, 2022



Esketamine nasal spray plus a new oral antidepressant is effective and well-tolerated among patients with treatment-resistant depression.

Data were derived from 2 long-term phase 3 trials involving patients with treatment-resistant major depressive disorder who had not responded to > 2 oral antidepressant medications.

The trial participants were treated with a new oral antidepressant plus esketamine nasal spray (56 or 84 mg biw) during the 4-week induction phase, then weekly x 5 w, and weekly or qow during maintenance. The incidence, frequency, and severity of adverse events were the outcomes of interest in the post hoc analysis.

Nine hundred twenty-eight patients with treatment-resistant depression were enrolled in the trials.

The following symptoms and incidences occurred after the 1st week of treatment: dizziness, 20.6%; nausea, 14.0%; vertigo, 12.1%; increased blood pressure, 4.3%; and sedation, 3.8%.