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 9 publications

(3 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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“…In 2019, the United States Food and Drug Administration (FDA) approved the S-enantiomer 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 – 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 FDA-mandated 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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Comment on “Efficacy and Safety of Subcutaneous Esketamine in the Treatment of Suicidality in Major Depressive Disorder and Bipolar Depression”

Wilkowska

Cuba

2022

Clin Drug Investig

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

Cited by 9 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

Evaluating passive physiological data collection during Spravato treatment

Comment on “Efficacy and Safety of Subcutaneous Esketamine in the Treatment of Suicidality in Major Depressive Disorder and Bipolar Depression”

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