Efficacy and Safety of Subcutaneous Esketamine in the Treatment of Suicidality in Major Depressive Disorder and Bipolar Depression

Surjan, Juliana; Grossi, Julia Diniz; Porto, José Alberto Del; Delfino, Rodrigo Simonini; Cerqueira, Raphael de Oliveira; Lucchese, Ana Cecília; Magalhães, Edno; Sant, Lorena Catarina Del; Tuena, Marco Aurélio; Nakahira, Carolina; Fava, Victor Augusto Rodovalho; Steglich, Matheus Souza; Abdo, Guilherme; Barbosa, Matheus; Sarin, Luciana Maria; Lacerda, Acioly Luiz Tavares de

doi:10.1007/s40261-022-01193-z

Cited by 13 publications

(7 citation statements)

References 52 publications

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“…The majority of the studies discussed are open-label involving small cohorts, underscoring the need for more comprehensive research through large-scale RCTs with extended follow-up durations. Presented research also suggest ketamine's antisuicidal properties with only one study reporting worsening in this symptomatic dimension (17,23,32,35). The risk of the affective switch seems low, and transient self-limiting adverse effects like drowsiness, dizziness, blurred vision, nausea, dissociative symptoms, and headaches confirm the good safety profile of ketamine in BD (12).…”

Section: Discussionmentioning

confidence: 73%

“…Reported side effects (i.e., feeling dizzy, cognitive impairment, dissociation, nausea, headache, odd sensations, flatulence, and blurred vision) were transient. The cases of discontinuation were rare (14, 16,18,19,21,23,24,32,35). One report of increased suicidality was described above and seems an isolated event (17).…”

Section: Ketamine Safety and Tolerability In Bipolar Depressionmentioning

confidence: 98%

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Short-term ketamine use in bipolar depression: a review of the evidence for short-term treatment management

Wilkowska,

Cubała

2023

Front. Psychiatry

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Bipolar depression constitutes a major problem in psychiatry. It correlates with high suicidality, treatment resistance, chronicity, and poor quality of life. Registered treatment for bipolar depression is limited and insufficient. There is an urgent need for implementing new therapeutic strategies. Intranasal ketamine’s enantiomer—esketamine is a novel rapid-acting antidepressant with proven efficacy in treatment-resistant depression. Research on bipolar depression, although not as comprehensive, indicates that it may be a viable and safe substitute with minimal risk for mood polarity changes. Reports suggest that ketamine treatment in bipolar depression may reduce suicidal tendencies, decrease anhedonia, and alleviate anxiety. Ketamine’s mood-stabilizing properties are also hypothesized. In this narrative review, we focus on ketamine use as an add-on to standard medication for the acute treatment of bipolar depression.

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Section: Discussionmentioning

confidence: 73%

Section: Ketamine Safety and Tolerability In Bipolar Depressionmentioning

confidence: 98%

Short-term ketamine use in bipolar depression: a review of the evidence for short-term treatment management

Wilkowska,

Cubała

2023

Front. Psychiatry

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Section: Subcutaneous Esketaminementioning

confidence: 99%

“…Ketamine and esketamine are usually referred to as anesthetic medications with high safety factor and effectiveness, but researchers have recently explored their potential as new therapies for UD and BD's depressive episode [16]. Ketamine can efficiently reduce the depressive symptoms in two hours after the infusion and the effects can peak in 24 hours, and the high efficiency has established its position in BD and UD treatment [16]. In a study, esketamine is given to both UD and BD patients to observe the medication's impact on their symptoms, and it is observed that the efficacy of esketamine doesn't vary between the BD group and UD group, lowering their Montgomery-Asberg Depression Rating Scale (MADRS) scores significantly [16].…”

Section: Subcutaneous Esketaminementioning

confidence: 99%

Diagnosis and treatment of unipolar and bipolar depression in the early stage

Shi

2023

TNS

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Bipolar Disorder and Unipolar Depressive Disorder are both mental disorders that contain depressive episodes, and the patterns of depression are similar between the two diseases. People are likely to meet their clinicians for the first time when they experience depression while there is no significant evidence of the existence of mania episodesthe other episode of bipolar disorder. Therefore, it is likely that the clinicians misdiagnose the disorder, thus prescribing the wrong medication or applying therapies harmful to patients. For example, some antidepressants will stimulate the mania episode of bipolar patients, increasing the frequency of switch between extreme depression and mania, thus developing the results of bipolar disorder in the patients. At the same time, some mood stabilizers are not that effective to cure major depression compared to medication specialized in treating depression. This article aims at providing several diagnostic methods that can differentiate bipolar and unipolar disorders, and introducing some plausible therapies that work for the two disorders at the same time without severe harm or exacerbation.

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“…In 2019, the United States Food and Drug Administration (FDA) approved the Senantiomer form of ketamine, esketamine (brand name Spravato), for use in patients with Treatment-Resistant Depression (TRD) and Major Depressive Disorder (MDD) with suicidal ideation. Spravato's efficacy has been demonstrated in numerous follow-on studies in a variety of populations (5,(7)(8)(9)(10)(11)(12)(13). While Spravato's efficacy and the need for new mental health treatments has driven significant growth, a major limitation to more rapid and accessible uptake is the monitoring requirements necessary during and after Spravato dosing as a part of its FDAmandated Risk Evaluation and Mitigation Strategy (REMS) program (14,15).…”

Section: Introductionmentioning

confidence: 99%

Evaluating passive physiological data collection during Spravato treatment

Solomon,

Hajduk,

Majernik

et al. 2023

Front. Digit. Health

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Spravato and other drugs with consciousness-altering effects show significant promise for treating various mental health disorders. However, the effects of these treatments necessitate a substantial degree of patient monitoring which can be burdensome to healthcare providers and may make these treatments less accessible for prospective patients. Continuous passive monitoring via digital devices may be useful in reducing this burden. This proof-of-concept study tested the MindMed Session Monitoring System™ (MSMS™), a continuous passive monitoring system intended for use during treatment sessions involving pharmaceutical products with consciousness-altering effects. Participants completed 129 Spravato sessions with MSMS at an outpatient psychiatry clinic specializing in Spravato treatment. Results indicated high rates of data quality and self-reported usability among participants and health care providers (HCPs). These findings demonstrate the potential for systems such as MSMS to be used in consciousness-altering treatment sessions to assist with patient monitoring.

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Efficacy and Safety of Subcutaneous Esketamine in the Treatment of Suicidality in Major Depressive Disorder and Bipolar Depression

Cited by 13 publications

References 52 publications

Short-term ketamine use in bipolar depression: a review of the evidence for short-term treatment management

Short-term ketamine use in bipolar depression: a review of the evidence for short-term treatment management

Diagnosis and treatment of unipolar and bipolar depression in the early stage

Evaluating passive physiological data collection during Spravato treatment

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