Rapid and long-lasting effects of subcutaneous esketamine on suicidality: an open-label study in patients with treatment-resistant depression

Eduardo Igor Torquato Cardoso Lopes, Patrícia Cavalcanti-Ribeiro, Fernanda Palhano-Fontes, Kaike Thiê da Costa Gonçalves, Emerson Arcoverde Nunes, Nicole Bezerra de Medeiros Lima, Nestor Caetano Santos, Aldielyson Jorge Cavalcante de Brito, Draulio Barros de Araujo, Nicole Leite Galvão-Coelho

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    1 Citation (Scopus)

    Abstract

    Therapeutics for suicide management is limited, taking weeks to work. This open-label clinical trial with 18 treatment-resistant depressive patients tested subcutaneous esketamine (8 weekly sessions) for suicidality. We noted a rapid and enduring effect of subcutaneous esketamine, lasting from one week to six months post-treatment, assessed by the Beck Inventory for Suicidality (BSI). There was an immediate drop in suicidality, 24 h following the initial dose, which persisted for seven days throughout the eight-week dosing period. Additionally, this study is the first to examine a six-month follow-up after multiple administrations of subcutaneous esketamine, finding consistently lower levels of suicidality throughout this duration. Conversely, suicidality also was measured along the 8-weeks of treatment by a psychiatrist using the Montgomery-Asberg Depression Rating Scale (MADRS), which showed significant reduction only after two treatment sessions expanding until the last session. Moreover, notably, 61% of patients achieved remission on suicidality (MADRS). These results suggest that weekly subcutaneous esketamine injections offer a cost-effective approach that induces a rapid and sustained response to anti-suicide treatment. This sets the stage for further, more controlled studies to corroborate our initial observations regarding the effects of SC esketamine on suicidality.

    Original languageEnglish
    Pages (from-to)254-258
    Number of pages5
    JournalJournal of Psychiatric Research
    Volume176
    DOIs
    Publication statusPublished - 2024

    Bibliographical note

    Publisher Copyright:
    © 2024

    Keywords

    • Esketamine
    • Suicide
    • Treatment-resistant depression

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