Depression has been on the rise for years. There are many cases that do not respond to conventional therapy with medication. It has now been discovered that with the help of a special nasal spray it is possible to effectively treat even supposedly treatment-resistant depression.
A new study involving experts from Goethe University Frankfurt examined the effectiveness and safety of esketamine nasal spray in the treatment of treatment-resistant depression and compared it with treatment with quetiapine extended-release tablets, which are the recommended form of therapy. The results are published in the “New England Journal of Medicine”.
Depression is relatively often resistant to treatment
Many of the people (up to 30 percent) who suffer from severe depression do not benefit from treatment with medication. Those affected do not respond to antidepressants such as serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), the researchers explain.
In treatment-resistant people, increased rates of comorbidity, suicide attempts and completions, as well as more hospital admissions and early deaths can be found. This makes it clear how important it is to identify effective treatment options for those affected.
How does esketamine nasal spray affect depression?
The team now examined how two different forms of combination therapy affect treatment-resistant depression. A group of participants was treated with a combination of SSRI/SNRI and esketamine nasal spray.
A second group received combined treatment with SSRI/SNRI and quetiapine prolonged-release tablets, as recommended in the National Care Guideline for Unipolar Depression, the experts report.
Therapy with nasal spray more effective
The researchers found that the combined treatment with the nasal spray offered clear advantages in achieving remission in the eighth week and freedom from relapse by week 32 after remission.
“In the group that received esketamine nasal spray, 54 percent more patients were in remission in the eighth week than in the group that received quetiapine prolonged-release tablets,” explains study author Professor Dr. Andreas Reif in a press release.
Relapse rate lower through treatment with nasal spray
The relapse rate examined after six months was also lower for participants treated with nasal spray than was the case when taking quetiapine extended-release tablets.
Esketamine is known to have an analgesic effect, but in the dosage used here and when used as a nasal spray, it also has a pronounced antidepressant effect, emphasizes Professor Dr. Add ripe.
How does the nasal spray work?
The expert believes that this effect is due to the spray counteracting reduced neuronal plasticity in the brain, which is present in people with treatment-resistant depression. (as)