Search Here

Depression, particularly severe and treatment-resistant forms, poses a significant challenge in mental health care. Approximately one-third of patients do not respond to traditional antidepressants like selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), leading to higher risks of suicide, increased mortality and frequent hospitalizations.

The quest for effective therapies has led to a groundbreaking international Phase IIIb study by Janssen Pharmaceutical Companies of Johnson & Johnson, in collaboration with University Hospital Frankfurt. The study compared the efficacy of two combination therapies: an SSRI/SNRI with esketamine nasal spray, and an SSRI/SNRI with quetiapine extended-release, a standard augmentation therapy recommended for unipolar depression.

The study's results, published in the New England Journal of Medicine, were remarkable. The group treated with esketamine nasal spray showed a higher rate of remission at Week 8 and maintained this improvement through Week 32, demonstrating esketamine's effectiveness in patients with treatment-resistant depression (TRD).

Esketamine, typically known for its analgesic properties in anesthesiology, also exhibits potent antidepressant effects when administered nasally. This novel approach is believed to counteract the reduced neuronal plasticity observed in TRD patients. Remarkably, 27.1% of patients in the esketamine group, who had been suffering from depression for over a year, achieved remission by Week 8, compared to 17.6% in the quetiapine group.

Moreover, esketamine nasal spray maintained its superiority over quetiapine in both remission rates and relapse prevention after six months, highlighting its potential as a robust treatment option for TRD, according to SciTechDaily.

The study, known as the ESCAPE-TRD Ph 3b study, was a multinational effort involving 171 facilities and nearly 700 patients across 24 countries. Alongside University Hospital Frankfurt, the Fraunhofer Institute for Translational Medicine and Pharmacology ITMP in Frankfurt also played a crucial role. This collaborative effort aimed to evaluate the efficacy, safety and tolerability of esketamine nasal spray compared to quetiapine extended-release, both in conjunction with ongoing SSRI/SNRI therapy.

The findings, which signified a major advancement in the treatment of TRD, underscored the potential of esketamine nasal spray as a more effective augmentation strategy in managing severe depression.