Treating bipolar depression with esketamine: Safety and effectiveness data from a naturalistic multicentric study on esketamine in bipolar versus unipolar treatment‐resistant depression
View/ Open
Author
the REAL‐ESK Study Group
Martinotti, Giovanni
Dell'Osso, Bernardo
Di Lorenzo, Giorgio
Maina, Giuseppe
Bertolino, Alessandro
Clerici, Massimo
Barlati, Stefano
Rosso, Gianluca
Di Nicola, Marco
Marcatili, Matteo
d'Andrea, Giacomo
Cavallotto, Clara
Chiappini, Stefania
De Filippis, Sergio
Nicolò, Giuseppe
De Fazio, Pasquale
Andriola, Ileana
Zanardi, Raffaella
Nucifora, Domenica
Di Mauro, Stefania
Bassetti, Roberta
Pettorruso, Mauro
McIntyre, Roger S.
Sensi, Stefano L.
di Giannantonio, Massimo
Vita, Antonio
Baldacci, Giulia
Belletti, Sandro
Bellomo, Antonello
Benatti, Beatrice
Carminati, Matteo
Carullo, Rosalba
de Berardis, Domenico
de Filippis, Renato
Chiaie, Roberto Delle
di Carlo, Francesco
Di Petta, Gilberto
Galluzzo, Alessandro
Giorgelli, Valentina
Lombardozzi, Ginevra
Martiadis, Vassilis
Mattei, Chiara
Mosca, Alessio
Niolu, Cinzia
Olivola, Miriam
Percudani, Mauro
Pepe, Maria
Rossi, Eros
Scardigli, Maria Ilaria
Tatì, Filippo
Attention
2299/26021
Abstract
Background: Bipolar depression accounts for most of the disease duration in type I and type II bipolar disorder (BD), with few treatment options, often poorly tolerated. Many individuals do not respond to first‐line therapeutic options, resulting in treatment‐resistant bipolar depression (B‐TRD). Esketamine, the S‐enantiomer of ketamine, has recently been approved for treatment‐resistant depression (TRD), but no data are available on its use in B‐TRD. Objectives: To compare the efficacy of esketamine in two samples of unipolar and bipolar TRD, providing preliminary indications of its effectiveness in B‐TRD. Secondary outcomes included the evaluation of the safety and tolerability of esketamine in B‐TRD, focusing on the average risk of an affective switch. Methods: Thirty‐five B‐TRD subjects treated with esketamine nasal spray were enrolled and compared with 35 TRD patients. Anamnestic data and psychometric assessments (Montgomery‐Asberg Depression Rating Scale/MADRS, Hamilton‐depression scale/HAM‐D, Hamilton‐anxiety scale/HAM‐A) were collected at baseline (T0), at one month (T1), and three months (T2) follow up. Results: A significant reduction in depressive symptoms was found at T1 and T2 compared to T0, with no significant differences in response or remission rates between subjects with B‐TRD and TRD. Esketamine showed a greater anxiolytic action in subjects with B‐TRD than in those with TRD. Improvement in depressive symptoms was not associated with treatment‐emergent affective switch. Conclusions: Our results supported the effectiveness and tolerability of esketamine in a real‐world population of subjects with B‐TRD. The low risk of manic switch in B‐TRD patients confirmed the safety of this treatment.
Publication date
2023-01-18Published in
Bipolar DisordersPublished version
https://doi.org/10.1111/bdi.13296Other links
http://hdl.handle.net/2299/26021Metadata
Show full item recordRelated items
Showing items related by title, author, creator and subject.
-
Comorbid depression in obsessive compulsive disorder (OCD) : Symptomatic differences to major depressive disorder
Fineberg, Naomi; Fourie, H.; Gale, T.M.; Sivakumaran, T. (2005)In this study, we compared the depressive symptom profile of a group of obsessive compulsive disorder (OCD) patients, with comorbid depression, to a group of patients with major depressive disorder (MDD). The two groups ... -
Still sad after successful renal transplantation : are we failing to recognise depression? An audit of depression screening in renal graft recipients
Spencer, B.W.; Chilcot, J.; Farrington, Ken (2010)Background: Depression is common in chronic physical illness, including renal graft recipients. There is evidence that depression is an independent marker of poorer prognosis in dialysis patients. In the UK, screening is ... -
Depression and clinical outcomes in CKD: do anti-depressants play a role? (EQUAL study)
Chilcot, Joseph; Picariello, Federica; Farrington, Ken (2022-08-01)