TY - JOUR
T1 - Oral Esketamine as Alternative for Maintenance Electroconvulsive Therapy in Patients with Treatment-Resistant Depression
T2 - A Case Series
AU - Coerts, Daniël T.
AU - Veraart, Jolien K.E.
AU - Kamphuis, Jeanine
AU - Smith-Apeldoorn, Sanne Y.
AU - Schoevers, Robert A.
AU - Van Belkum, Sjoerd M.
N1 - Publisher Copyright:
Copyright © 2025 Wolters Kluwer Health, Inc.
PY - 2025/1/21
Y1 - 2025/1/21
N2 - Objectives: This study investigates repeated oral esketamine as a substitution strategy for maintenance electroconvulsive therapy (M-ECT) in eight patients with treatment-resistant depression (TRD).Methods: In a 6-week dosing phase, esketamine was titrated from 0.5 or 1.0 mg/kg to a maximum of 3.0 mg/kg twice weekly. Outcomes included 6-week change in Inventory of Depressive Symptomatology - Self-rated (IDS-SR), Hamilton Depression Rating Scale - 17 items (HDRS17), and Outcome Questionnaire 45 (OQ-45), along with esketamine treatmentcontinuation.Results: Depression severity remained stable or improved in five patients, whereas three experienced worsening symptoms and resumed M-ECT. OQ-45 scores were available for five patients, all of whom showed improvement. Currently, four patients are still receiving oral esketamine.Conclusions: Repeated oral esketamine may be a suitable and patient-friendly alternative to M-ECT. We recommend controlled trials to compare long-term safety and efficacy.
AB - Objectives: This study investigates repeated oral esketamine as a substitution strategy for maintenance electroconvulsive therapy (M-ECT) in eight patients with treatment-resistant depression (TRD).Methods: In a 6-week dosing phase, esketamine was titrated from 0.5 or 1.0 mg/kg to a maximum of 3.0 mg/kg twice weekly. Outcomes included 6-week change in Inventory of Depressive Symptomatology - Self-rated (IDS-SR), Hamilton Depression Rating Scale - 17 items (HDRS17), and Outcome Questionnaire 45 (OQ-45), along with esketamine treatmentcontinuation.Results: Depression severity remained stable or improved in five patients, whereas three experienced worsening symptoms and resumed M-ECT. OQ-45 scores were available for five patients, all of whom showed improvement. Currently, four patients are still receiving oral esketamine.Conclusions: Repeated oral esketamine may be a suitable and patient-friendly alternative to M-ECT. We recommend controlled trials to compare long-term safety and efficacy.
KW - chart review
KW - difficult-to-treat depression
KW - ketamine
KW - major depressive disorder
KW - treatment resistance
UR - http://www.scopus.com/inward/record.url?scp=85216995561&partnerID=8YFLogxK
U2 - 10.1097/YCT.0000000000001103
DO - 10.1097/YCT.0000000000001103
M3 - Article
C2 - 39853300
AN - SCOPUS:85216995561
SN - 1095-0680
JO - Journal of ECT
JF - Journal of ECT
ER -