Citation

Rothärmel M, Benosman C, El-Hage W, Berjamin C, Ribayrol D, Guillin O, Gaillard R, Berkovitch L, Moulier V. Front. Psychiatry 2022; 13.

Copyright

(Copyright © 2022, Frontiers Media)

DOI

10.3389/fpsyt.2022.865466

PMID

unavailable

Abstract

INTRODUCTION: Major depressive disorder (MDD) is more likely to resist to usual treatment when it is associated with post-traumatic stress disorder (PTSD). Capitalizing on the effect of ketamine in both treatment-resistant depression (TRD) and PTSD, we conducted a study in order to assess the efficacy of intranasal (IN) Esketamine in patients having TRD with comorbid PTSD.

MATERIALS AND METHODS: In this open-label, single arm, retrospective pilot study, 11 patients were treated with IN Esketamine (56 or 84 mg) with a longitudinal follow-up of 6 months. IN Esketamine was administered twice weekly during the first month, once weekly during the second month, and then once every 1 or 2 weeks. Patients were assessed with Montgomery-Åsberg Depression Rating Scale (MADRS), Patient Health Questionnaire 9 items, Global Assessment of Functioning (GAF), and Clinical Global Impression-Suicide Scale (CGI-SS).

RESULTS: We included 9 women and 2 men (mean age 47.3 ± 11.1 years). The mean (SD) MADRS scores decreased significantly from 38.6 (6.4) at baseline to 18.2 (10.03) after 6 months of IN Esketamine; 7 patients were responders and 3 patients were in remission. The percentage of patients who were moderately to severely suicidal declined from 63.6% at baseline to 27.3% after 1 month of IN Esketamine sessions. No serious adverse reactions were observed.

CONCLUSION: This study reports the outcomes of 11 severely ill patients with comorbid TRD and PTSD after IN Esketamine treatment. Esketamine significantly improved depression symptoms, suggesting that it is likely to be a treatment of choice in this specific population. Copyright © 2022 Rothärmel, Benosman, El-Hage, Berjamin, Ribayrol, Guillin, Gaillard, Berkovitch and Moulier.

Language: en

Keywords

adult; human; female; male; psychotherapy; pilot study; post-traumatic stress disorder; suicidal behavior; comorbidity; disease severity; longitudinal study; posttraumatic stress disorder; controlled study; retrospective study; clinical article; sedation; serotonin uptake inhibitor; tricyclic antidepressant agent; somnolence; drug choice; drug safety; benzodiazepine derivative; drug efficacy; risk benefit analysis; nausea; drug withdrawal; hypertension; side effect; atypical antipsychotic agent; antiemetic agent; dizziness; mood stabilizer; treatment response; Montgomery Asberg Depression Rating Scale; Article; alpha 2 adrenergic receptor blocking agent; drug dose increase; drug dose titration; outcome assessment; treatment duration; open study; Clinical Global Impression scale; serotonin noradrenalin reuptake inhibitor; drug dose comparison; Global Assessment of Functioning; treatment resistant depression; Patient Health Questionnaire 9; mental dissociation; treatment-resistant depression; esketamine; Esketamine; assisted-therapy; Clinical Global Impression Suicide Scale; trauma-focused psychotherapy