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Trajectory of response to esketamine nasal spray for treatment resistant depression

2026Artigo científico Acesso aberto
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dc.contributor.authorYoung, A. H.
dc.contributor.authorBartova, L.
dc.contributor.authorCardoner, N.
dc.contributor.authorDemyttenaere, K.
dc.contributor.authorFagiolini, A.
dc.contributor.authorGodinov, Y.
dc.contributor.authorGolib Dzib, J. F.
dc.contributor.authorVon Holt, C.
dc.contributor.authorMcintyre, R. S.
dc.contributor.authorOliveira-Maia, A. J.
dc.contributor.authorRive, B.
dc.contributor.authorGorwood, P.
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.pblEuropean Psychiatric Association | Cambridge University Press
dc.date.accessioned2026-06-25T12:58:02Z
dc.date.available2026-06-25T12:58:02Z
dc.date.issued2026
dc.descriptionPublisher Copyright: © The Author(s), 2026. Published by Cambridge University Press on behalf of European Psychiatric Association.
dc.description.abstractPrevious research has demonstrated the positive impact of early remission on disease trajectory for patients with major depressive disorder. However, there is a paucity of literature assessing response trajectory for patients with treatment resistant depression (TRD). These analyses investigated patient outcome trajectories to Week 32, including the relationship between short- and long-term outcomes with esketamine nasal spray (ESK-NS) treatment and symptom resolution. ESCAPE-TRD (NCT04338321), a randomised, open-label, phase IIIb study, evaluated the efficacy and safety of ESK-NS versus quetiapine extended release (QTP-XR) in patients with TRD. Rater-blinded Montgomery-Åsberg Depression Rating Scale (MADRS) total score was used to assess depressive symptoms and trajectory of patient responses to Week 32. For ESK-NS versus QTP-XR, time to symptom resolution across MADRS items was evaluated using Kaplan-Meier analyses. Of 676 patients, 336 and 340 were randomised to ESK-NS and QTP-XR, respectively. Most ESK-NS-treated patients achieved continuously improved outcomes to Week 32; early response was associated with better long-term outcomes. Among patients who achieved Week 4 response, 89.6% achieved remission at any point from Week 4-32; 78.3% of Week 8 responders achieved remission at any point from Week 8- 32. Greater and earlier symptom resolution was observed with ESK-NS versus QTP XR across most MADRS items. Most ESK-NS-treated patients with TRD showed continuous improvements over time, with short-term response associated with better long-term outcomes. Long-term improvements were observed even among partial/minimal early responders, reinforcing the value of longer treatment. ESK-NS had positive impact across the full 71 spectrum of MADRS-assessed symptoms.en
dc.description.versionauthorsversion
dc.description.versioninpress
dc.format.extent2241634
dc.identifier.doi10.1192/j.eurpsy.2026.12229
dc.identifier.issn0924-9338
dc.identifier.otherPURE: 165798089
dc.identifier.otherPURE UUID: d53cec0a-7415-429e-86ab-fc4093a7cace
dc.identifier.otherScopus: 105042150910
dc.identifier.urihttp://hdl.handle.net/10362/204077
dc.identifier.urlhttps://www.scopus.com/pages/publications/105042150910
dc.language.isoeng
dc.peerreviewedyes
dc.subjectesketamine
dc.subjectlong-term outcomes
dc.subjecttrajectory of response
dc.subjecttreatment resistant depression
dc.subjectPsychiatry and Mental health
dc.subjectSDG 3 - Good Health and Well-being
dc.titleTrajectory of response to esketamine nasal spray for treatment resistant depressionen
dc.title.subtitlefindings from ESCAPE-TRDen
dc.typejournal article
degois.publication.titleEuropean Psychiatry
dspace.entity.typePublication
rcaap.rightsopenAccess

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