Use of Esketamine in the Treatment of Depression: A Systematic Review of Clinical Evidence

Main Article Content

Cristianne Confessor Castilho Lopes
Vitor Ohana Marques Azzini
Eduardo Barbosa Lopes
Fábio Herget Pitanga
Lucas Castilho Lopes
Maria Eduarda Castilho Lopes
Rodrigo Telles de Proença
Caroline Quintino
Larissa Silva Guimarães
Daniel Furlan
Sheron Adriany da Rosa Bugs
Isabela Aiolfi
Pedro Henrique Rocha Caldeira
Gerson Luiz de Macedo
Tiago Taison Silveira

Abstract

Introduction: Depression is a highly prevalent psychiatric condition and considered one of the leading causes of disability worldwide, affecting millions of individuals across different age groups and social contexts. Esketamine, a ketamine derivative, has emerged as a promising option for the treatment of resistant depression.


Objective: To synthesize the available evidence on the use of esketamine in depressed patients, focusing on its efficacy, safety, and possible limitations.  


Methods: This study is a systematic review, classified as exploratory and descriptive. The research was carried out through bibliographic research in electronic databases on methods associated with SLR (Systematic Literature Review) and applications of SMARTER (Simple Multi-Attribute Rating Technique using Exploiting Rankings).


Results: A comprehensive systematic search of the literature yielded a total of 1270 articles related to the topic addressed, of which 34 articles were eligible to compose this systematic review. Conclusion: With the advancement of research and the adaptation of health structures, the estimate has the potential to transform the management of resistance depression, significantly improving quality of life.   

Article Details

How to Cite
Cristianne Confessor Castilho Lopes, Vitor Ohana Marques Azzini, Eduardo Barbosa Lopes, Fábio Herget Pitanga, Lucas Castilho Lopes, Maria Eduarda Castilho Lopes, Rodrigo Telles de Proença, Caroline Quintino, Larissa Silva Guimarães, Daniel Furlan, Sheron Adriany da Rosa Bugs, Isabela Aiolfi, Pedro Henrique Rocha Caldeira, Gerson Luiz de Macedo, & Tiago Taison Silveira. (2024). Use of Esketamine in the Treatment of Depression: A Systematic Review of Clinical Evidence. International Journal of Medical Science and Clinical Research Studies, 4(11), 2042–2049. https://doi.org/10.47191/ijmscrs/v4-i11-17
Section
Articles

References

I. AASS, LK; MOEN, Ø. L.; SKUNDBERG - KLETTHAGEN, H.; LUNDQVIST, L.; SCHRÖDER, A. Family support and quality of community mental health care: Perspectives from families living with mental illness. Journal of Clinical Nursing , v. 31, no. 7–8, p. 935–948, 8 Apr. 2022.

II. AURELIO, SM; HOTH, N. OF AC; SAVARIEGO, B. OF OB; PAIVA, A. C.; DIAS, AP; SOUSA, LL OF L.; CHAVES, F.GM.; CORRÊA, I. OF M.; BEZERRA, LST; PINHEIRO, RB; ROCHA, EHR; ARAÚJO NETO, AC DA S.; MORAES, AT DE. Deep Brain Stimulation Therapy for Treatment-Resistant Psychiatric Disorders. Brazilian Journal of Implantology and Health Sciences , v. 6, n. 6, pp. 898–910, 13 Jun 2024.

III. BARBOSA, FC; DA SILVEIRA, FM; SHIOZAWA, P.; TADINE, RM; REZENDE, JDP; SAMUEL, BV A neuroscience perspective on interventional psychiatry. Management and Administrative Professional Review , v. 14, n. 4, p. 4540–4554, Apr 4, 2023.

IV. BRUNONI, AR; HAMANI, C.; QUEVEDO, J. Interventional Psychiatry . 1st ed.

V. CARVALHO, AJ; PIMENTA, SB DE B.; SIMEONI, AR Use of intranasal esketamine in the treatment of resistant depression: a literature review. Research, Society and Development , v. 11, n. 16, p. e430111638613, Dec 18, 2022.

VI. CEBAN, F. et al. Prevention and Management of Common Adverse Effects of Ketamine and Esketamine in Patients with Mood Disorders. CNS Drugs , vol. 35, no. 9, p. 925–934, Sept. 2021.

VII. CHEN, G.; CHEN, L.; ZHANG, Y.; LI, X.; LANE, R.; LIM, P.; DALY, EJ; FUREY, ML; FEDGCHIN, M.; POPOVA, V. Relationship between dissociation and antidepressant effects of esketamine nasal spray in patients with treatment-resistant depression. International Journal of Neuropsychopharmacology , vol. 25, no. 4, p. 269–279, 2022.

VIII. CHEVALIER, L.; BULTEAU, S.; CHEVAL, L.; CHARRON, J.; SAUVAGET, A.; LAURIN, A. Differed spontaneous dissociative symptoms following the use of esketamine intranasal spray in a patient suffering from treatment-resistant depression: a case report. International Clinical Psychopharmacology , p. 10–1097, 2024.

IX. COOK, J.; HALARIS, A. Adjunctive dopaminergic enhancement of esketamine in treatment-resistant depression. Progress in Neuro-Psychopharmacology and Biological Psychiatry , vol. 119, p. 110603, 2022.

X. CORREIA, CAR Pharmacogenomic biomarkers as a source of evidence for effectiveness and safety in depression therapy Porto AlegreUniversity of Porto Alegre, , 2021. Available at: <https://sapientia.ualg.pt/entities/publication/dae38b93-ded9-4753 -835e-856775c769ef>

XI. D'ANDREA, G.; PETTORRUSO, M.; DI LORENZO, G.; MANCUSI, G.; MCINTYRE, RS; MARTINOTTI, G. Rethinking ketamine and esketamine action: are they antidepressants with mood-stabilizing properties? European Neuropsychopharmacology , vol. 70, p. 49–55, 2023.

XII. DE SÁ, LDM Pharmacy 5 de Outubro, Porto and Pharmaceutical Services of the CUF Hospital, Porto Porto - PortugalRepository Faculty of Pharmacy of the University of Porto, , 2022.

XIII. DEL SANT, LC Adverse effects of repeated subanesthetic doses of subcutaneous esketamine in treatment-resistant depression São PauloRepositório UNIFESP, , 2023. Available at: <https://repositorio.unifesp.br/server/api/core/bitstreams/d8612955-5f29-4e6e-8799-36f138986f86/content>

XIV. ELISABETSKY, E.; HERRMANN, AP; PIATO, A.; DE MOURA LINCK, V. Making psychopharmacology uncomplicated: Psychopharmaceuticals for clinical and recreational use . Porto Alegre - RS: Editora Blucher, 2021.

XV. HALARIS, A.; COOK, J. The glutamatergic system in treatment-resistant depression and comparative effectiveness of ketamine and esketamine: role of inflammation? In: Neuroinflammation, Gut-Brain Axis and Immunity in Neuropsychiatric Disorders . Singapore: Springer, 2023. p. 487–512.

XVI. JAGTIANI, A. Novel treatments of depression: bridging the gap in current therapeutic approaches. Exploration of Neuroscience , vol. 3, no. 4, p. 272–286, 9 Jul. 2024.

XVII. JIANG, M.; LI, Q.; MAO, M.; Xu, C.; ZHOU, R.; WEN, Y.; YUAN, H.; FENG, S. Evaluation of clinical effects of Esketamine on depression in patients with missed miscarriage: A randomized, controlled, double-blind trial. Journal of Affective Disorders , vol. 329, p. 525–530, 2023.

XVIII. JOHNSTON, JN; ZARATE JR, CA; KVARTA, MD Esketamine in depression: putative biomarkers from clinical research. European Archives of Psychiatry and Clinical Neuroscience , p. 1–14, 2024.

XIX. KIELING, C.; BUCHWEITZ, C.; CAYE, A.; SILVANI, J.; AMEIS, SH; BRUNONI, AR; COST, KT; COURTNEY, DB; GEORGIADES, K.; MERIKANGAS, KR; HENDERSON, JL; POLANCZYK, GV; ROHDE, LA; SALUM, GA; SZATMARI, P. Worldwide Prevalence and Disability From Mental Disorders Across Childhood and Adolescence. JAMA Psychiatry , vol. 81, no. 4, p. 347, 1 Apr. 2024.

XX. KRYSTAL, JH; KAVALALI, ET; MONTEGGIA, LM Ketamine and rapid antidepressant action: new treatments and novel synaptic signaling mechanisms. Neuropsychopharmacology , vol. 49, n. 1, p. 41–50, 2024.

XXI. LANGMIA, IM; JUST, KS; YAMOUNE, S.; MÜLLER, JP; STINGL, JC Pharmacogenetic and drug interaction aspects on ketamine safety in its use as antidepressant - implications for precision dosing in a global perspective. British Journal of Clinical Pharmacology , vol. 88, no. 12, p. 5149–5165, 2022.

XXII. MALLEY, S.; TANAKA, H. Pharmacological management of treatment-resistant depression: current approaches and future directions. Archives of Clinical Psychiatry , vol. 50, no. 1, p. 84–91, 2023.

XXIII. MARX, W.; PENNINX, BWJH; SOLMI, M.; FURUKAWA, TA; FIRTH, J.; CARVALHO, AF; BERK, M. Major depressive disorder. Nature Reviews Disease Primers , vol. 9, no. 1, p. 44, 24 Aug. 2023.

XXIV. MAWERE-MUBVUMBI, TP S-ketamine: Is it a ride worth taking? Adverse effects associated with S-ketamine use as an adjuvant or single agent drug. Trends in Anesthesia and Critical Care , vol. 49, p. 101233, 2023.

XXV. MCINTYRE, RS et al. Treatment - resistant depression: definition, prevalence, detection, management, and investigational interventions. World Psychiatry , vol. 22, no. 3, p. 394–412, 15 Oct. 2023.

XXVI. MOLERO, P.; AUBÁ, E.; UNCETA, M. DEL M.; ORTUÑO SÁNCHEZ-PEDREÑO, F. The Modulation of Glutamatergic Signaling as a Potential Therapeutic Strategy for Major Depression. In: PAVLOVIC, ZM (Ed.). . Glutamate and Neuropsychiatric Disorders: Current and Emerging Treatments . 1st ed. [sl] Springer, 2022. p. 337–357.

XXVII. PETTORRUSO, M.; GUIDOTTI, R.; D'ANDREA, G.; DE RISIO, L.; D'ANDREA, A.; CHIAPPINI, S.; CARULLO, R.; BARLATI, S.; ZANARDI, R.; ROSSO, G. Predicting outcome with Intranasal Esketamine treatment: A machine-learning, three-month study in Treatment-Resistant Depression (ESK-LEARNING). Psychiatry Research , vol. 327, p. 115378, 2023.

XXVIII. RATO, MAB Esketamine and Treatment-Resistant Depression: A Systematic Review CoimbraFaculty of Medicine, University of Coimbra, , 2022. Available at: <https://estudogeral.uc.pt/handle/10316/102317?mode=full>

XXIX. ROTHÄRMEL, M.; BENOSMAN, C.; EL-HAGE, W.; BERJAMIN, C.; RIBAYROL, D.; GUILLIN, O.; GAILLARD, R.; BERKOVITCH, L.; MOULIER, V. Efficacy and safety of intranasal esketamine in patients with treatment-resistant depression and comorbid chronic post-traumatic stress disorder: open-label single-arm pilot study. Frontiers in psychiatry , vol. 13, p. 865466, 2022.

XXX. TAMMAN, A.; ANAND, A.; MATHEW, SJ A comparison of the safety, feasibility, and tolerability of ECT and ketamine for treatment-resistant depression. Expert Opinion on Drug Safety , vol. 21, no. 6, p. 745–759, 3 jun. 2022.

XXXI. TAVARES, RF; DE ARAÚJO, AV; SILVA, BC; DE FARIAS NETO, RCB Applicability of ketamine in refractory depression and suicidal ideation: an integrative literature review. Ibero-American Journal of Humanities, Sciences and Education , v. 10, n. 8, p. 3166–3174, 2024.

XXXII. VASILIU, O. Esketamine for treatment - resistant depression: A review of clinical evidence. Experimental and therapeutic medicine , vol. 25, no. 3, p. 1–10, 2023.

XXXIII. VOINESKOS, D.; DASKALAKIS, ZJ; BLUMBERGER, DM Management of Treatment-Resistant Depression: Challenges and Strategies. Neuropsychiatric Disease and Treatment , vol. Volume 16, p. 221–234, Jan. 2020.

XXXIV. YANG, H.; GAO, S.; LI, J.; YU, H.; Xu, J.; LIN, C.; YANG, H.; TENG, C.; MA, H.; ZHANG, N. Remission of symptoms is not equal to functional recovery: Psychosocial functioning impairment in major depression. Frontiers in psychiatry , vol. 13, p. 915689, 26 July. 2022.

Most read articles by the same author(s)