Esketamine and Hopelessness: Very Short-Term Effects

TL;DR

This study examines how esketamine affects hopelessness in patients with depression, finding a reduction in hopelessness scores after one month of treatment.

Contribution

The paper provides early evidence on esketamine's impact on hopelessness, a key factor in suicide risk.

Findings

Patients showed an average decrease in hopelessness scores from 14.6 to 7.4 after one month.

The median hopelessness score decreased from 14 to 8.

Improvement in hopelessness may suggest potential benefits for reducing suicide risk.

Abstract

Treatment Resistant Depression is a challenging condition with a poor outcome and limited therapeutic options. Esketamine is the enantiomer of Ketamine and has recently been approved and marketed for treating depression. Questions remain about its short- and long-term benefit, as well as its usefulness in suicide risk. Hopelessness is one of the symptoms most closely associated with suicide risk.

The aim of this paper is to evaluate the effect of this drug on hopelessness after one month of treatment with Esketamine.

The Beck Hopelessness Scale (BHS) was administered to patients receiving Esketamine at the Doctor Negrín University Hospital of Gran Canaria, who provided informed consent and exhibited suicidal ideations and depressive symptoms at the beginning of treatment. This scale was administered before the intranasal administration of Esketamine and after one month of treatment.

Participants (n=5) had an average age of 54,4 years (median 56). We observed variability in the results among the evaluated patients, although the overall trend was a decrease in scores. On average, the patients’ scores decreased from 14,6 to 7,4 points (with a median change from 14 to 8 points).

Hopelessness improved in the BHS after one month of treatment with Esketamine. These results could be of clinical significance. Hopelessness is associated with suicide risk, so we hypothesize that the improvement could have an impact on it. Nevertheless, we must exercise caution with these results: the sample size is small, patients were taking different medications, and they have diverse medical histories.

None Declared