Repeated subcutaneous esketamine on treatment-resistant depression: an open-label dose titration study

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dc.contributor.authorFontes, Fernanda Palhano Xavier de
dc.contributor.authorRibeiro, Patricia Cavalcanti
dc.contributor.authorGonçalves, Kaike Thiê da Costa
dc.contributor.authorAlmeida, Victor Rocha Nobrega de
dc.contributor.authorBarbosa, David Cavalcante
dc.contributor.authorFerreira, Marcos André de Araújo
dc.contributor.authorBolcont, Raynara
dc.contributor.authorSouza, Lara Carvalho Araújo Melo de
dc.contributor.authorSantos, Nestor Caetano
dc.contributor.authorLopes, Eduardo Igor Torquato Cardoso
dc.contributor.authorLima, Nicole Bezerra de Medeiros
dc.contributor.authorBrito, Aldielyson Jorge Cavalcanti de
dc.contributor.authorCarvalho, Marcelo Falchi
dc.contributor.authorArcoverde, Emerson Nunes
dc.contributor.authorAraújo, Draulio Barros de
dc.contributor.authorCoelho, Nicole Leite Galvão
dc.contributor.authorIDhttps://orcid.org/0000-0002-1612-6703
dc.contributor.authorIDhttps://orcid.org/0000-0003-3356-282X
dc.contributor.authorIDhttps://orcid.org/0009-0009-3600-4453
dc.contributor.authorIDhttps://orcid.org/0009-0005-3947-577X
dc.contributor.authorIDhttps://orcid.org/0000-0001-9376-3979
dc.contributor.authorIDhttps://orcid.org/0000-0002-3079-9533
dc.contributor.authorIDhttps://orcid.org/0009-0003-4723-4840
dc.contributor.authorIDhttps://orcid.org/0000-0002-2001-4536
dc.contributor.authorIDhttps://orcid.org/0000-0002-6934-2485
dc.contributor.authorIDhttps://orcid.org/0000-0002-4887-8635
dc.date.accessioned2026-01-22T16:06:03Z
dc.date.available2026-01-22T16:06:03Z
dc.date.issued2025-01-15
dc.description.resumoBackground: Ketamine has gained prominence as one of the most effective therapeutic options in unipolar treatment-resistant depression (TRD). However, most studies related to the antidepressant action of ketamine used intravenous (IV) or intranasal (IN) administration. The subcutaneous (SC) route of administration is a promising alternative, as it results in plasma levels comparable to IV, causes fewer side effects, and is easier and cheaper to administer than both IV and/or IN routes. Methods In this context, we conducted an open-label clinical trial for investigating the efficacy and safety of 8 weekly sessions of SC esketamine in TRD patients (n = 30). Results At the end of the treatment, a partial response rate of 26.09 %, a response rate of 52.17 % and remission rate of 34.78 % were observed, assessed by Montgomery-Åsberg Depression Rating Scale. Moreover, the self-reported depressive symptoms, as measured by the Beck Depression Inventory II (BDI-II), significantly decreased from the baseline to the final session, and the improvements were sustained throughout the week. Follow-up evaluations (BDI-II) up to the sixth month consistently showed scores lower than the baseline. Limitations The small sample size and the drop-out during the follow-up phase may limit the generalizability of the findings. Additionally, the absence of a control group necessitates cautious interpretation of causality. Conclusions This groundbreaking study, which addresses SC esketamine treatment for TRD, reported promising response and remission rates, as well as sustained antidepressant effects. It highlights the need for further research to improve and expand our knowledge of this innovative, more accessible, and cost-effective therapeutic approach
dc.identifier.citationFONTES, Fernanda Palhano Xavier de; RIBEIRO, Patricia Cavalcanti; GONÇALVES, Kaike Thiê da Costa; ALMEIDA, Victor Rocha Nobrega de; BARBOSA, David Cavalcante; FERREIRA, Marcos André de Araújo; BOLCONT, Raynara; SOUZA, Lara Carvalho Araújo Melo de; SANTOS, Nestor Caetano; LOPES, Eduardo Igor Torquato Cardoso; LIMA, Nicole Bezerra de Medeiros; BRITO, Aldielyson Jorge Cavalcanti de; CARVALHO, Marcelo Falchi; ARCOVERDE, Emerson Nunes; ARAÚJO, Draulio Barros de; COELHO, Nicole Leite Galvão. Repeated subcutaneous esketamine on treatment-resistant depression: An open-label dose titration study. Journal of Affective Disorders, v. 369, p. 155-163, 15 jan. 2025. DOI: https://doi.org/10.1016/j.jad.2024.09.141. Disponível em: https://www.sciencedirect.com/science/article/pii/S0165032724016306?via%3Dihub. Acesso em: 12 jan. 2026.
dc.identifier.doihttps://doi.org/10.1016/j.jad.2024.09.141
dc.identifier.issn1573-2517
dc.identifier.urihttps://repositorio.ufrn.br/handle/123456789/67912
dc.language.isoen
dc.publisherJournal of Affective Disorders
dc.subjectUnipolar depression
dc.subjectKetamine
dc.subjectSubcutaneous
dc.subjectTreatment-resistant depression
dc.titleRepeated subcutaneous esketamine on treatment-resistant depression: an open-label dose titration study
dc.typearticle

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