Tolerability of intranasal esketamine, a case series of 15 patients

TL;DR

This study examines how well 15 patients tolerate intranasal esketamine for treatment-resistant depression, finding mostly mild and temporary side effects.

Contribution

The study provides real-world tolerability data of intranasal esketamine in a small patient cohort.

Findings

The most common adverse effects were dissociation, dizziness, and somnolence, which were mild or moderate.

No patients discontinued treatment due to adverse effects.

Transient increases in blood pressure and worsening of obsessions were observed in some patients.

Abstract

Intranasal esketamine has recently been approved for the treatment of treatment-resistant depression in adults, with different studies showing its efficacy and tolerability. However, the real-world tolerability of this treatment is still unclear.

Evaluate the tolerability of intranasal esketamine in a case series of 15 patients.

Our case series includes 15 patients, who received treatment with intranasal esketamine during 2022-2023. In order to evaluate the tolerability of intranasal esketamine, patients were asked to complete the TSQM and a side effect questionnaire on different moments of the treatment (one week, six weeks and six months after the beginning of the treatment).

The most common adverse effects were dissociation, dizziness, and somnolence, which resolved within the hours following the administration. All of them were mild or moderate in severity, having a minor impact on the patient, so none of the patients discontinued the treatment due to adverse effects. Other adverse effects noticed were: transitory increment of blood pressure in several patients, and worsening of obsessions in a patient with previous obsessive-compulsive symptoms.

Our data suggests that intranasal esketamine is well tolerated, with transient and mild adverse effects. In all cases the risk-benefit ratio must be evaluated, but until more studies are done, it seems to be a safe treatment for treatment-resistant depression.

None Declared