An antidepressant nasal-spray can be a safe and effective way to treat depression in patients who do not respond to existing treatments, a study has found. Being common and treatment resistant, individuals with depression are often unable to relieve their symptoms despite trying anti-depressants, researchers said. According to the study published in the American Journal of Psychiatry, esketamine nasal spray, in conjunction with an oral antidepressant, offers a new fast-acting treatment for people that have not responded to other depression treatments.
"Not only was adjunctive esketamine therapy effective, the improvement was evident within the first 24 hours," said Michael Thase from the University of Pennsylvania in the US. "The novel mechanism of action of esketamine, coupled with the rapidity of benefit, underpin just how important this development is for patients with difficult to treat depression," said Thase.
The study was conducted on nearly 200 adults with moderate to severe depression and a history of not responding to at least two antidepressants. Participants were randomly assigned to one of two groups. One group was switched from their current treatment to esketamine nasal spray - 56 or 84 milligrammes twice weekly - plus a newly initiated antidepressant (duloxetine, escitalopram, sertraline, or extended-release venlafaxine). The other group was switched from their current treatment to a placebo nasal spray in combination with a new antidepressant.
The improvement in depression among those in the esketamine group was significantly greater than the placebo group at day 28. Similar improvements were seen at earlier points in time. The therapy was effective and the improvement was evident within the first 24 hours, said Thase. Researchers also pointed out that the esketamine group experienced common side effects like dissociation, nausea, vertigo, dysgeusia (distortion of the sense of taste) and dizziness which, however, resolved after 1.5 hours.