Intranasal Esketamine for Rapid Reduction of Suicidal Ideation in Treatment-Resistant Depression

New longitudinal data from Italy show intranasal esketamine produces a rapid, large reduction in suicidal ideation in patients with treatment‑resistant depression, with benefits enduring through six months.

The investigators used the C-SSRS to quantify suicidal ideation and the MADRS to assess depressive symptoms among 80 patients, with primary assessments at one week and six months.

In this cohort, 68.4% had an early suicidal‑ideation response at one week, and 62.5% achieved a sustained MADRS response at six months. Male sex was associated with lower odds of an early suicidal‑ideation response, indicating demographic variation in the rapid benefit.

Adverse events were chiefly transient dissociation and vertigo, supporting routine post‑dose observation and brief supportive care to manage these effects while preserving the rapid and durable clinical benefit.