PMID- 33888663
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210601
IS  - 1738-1088 (Print)
IS  - 2093-4327 (Electronic)
IS  - 1738-1088 (Linking)
VI  - 19
IP  - 2
DP  - 2021 May 31
TI  - Rapid Onset of Intranasal Esketamine in Patients with Treatment Resistant 
      Depression and Major Depression with Suicide Ideation: A Meta-Analysis.
PG  - 341-354
LID - 10.9758/cpn.2021.19.2.341 [doi]
AB  - OBJECTIVE: We performed a meta-analysis of randomized double-blinded placebo 
      controlled trials (DB-RCTs) to investigate efficacy and safety of intranasal 
      esketamine in treating major depressive disorder (MDD) including treatment 
      resistant depression (TRD) and major depression with suicide ideation (MDSI). 
      METHODS: Mean change in total scores on Montgomery-Asberg Depression Rating Scale 
      (MADRS) from baseline to different time-points were our primary outcome measure. 
      Secondary efficacy measures included rate of remission of depression and 
      resolution of suicidality. RESULTS: Eight DB-RCTs (seven published and one 
      un-published) covering 1,488 patients with MDD were included. Esketamine more 
      significantly improved MADRS total scores than placebo starting from 2-4 hours 
      after the first administration (standardized mean difference, -0.41 [95% CI, 
      -0.58 to -0.25], p < 0.00001), and this superiority maintained until end of 
      double-blinded period (28 days). Sub-group analysis showed that superior 
      antidepressant effects of esketamine over placebo in TRD and MDSI was observed 
      from 2-4 hours, which was maintained until 28 days. Resolution of suicide in MDSI 
      was also greater for esketamine than for placebo at 2-4 hours (OR of 2.04, 95% 
      CIs, 1.37 to 3.05, p = 0.0005), but two groups did not statistically differ at 24 
      hours and day 28. Total adverse events (AEs), and other common AEs including 
      dissociation, blood pressure increment, nausea, vertigo, dysgeusia, dizziness, 
      and somnolence were more frequent in esketamine than in placebo group. 
      CONCLUSION: Esketamine showed rapid antidepressant effects in patients with MDD, 
      including TRD and MDSI. The study also suggested that esketamine might be 
      associated with rapid anti-suicidal effects for patients with MDSI.
FAU - Wang, Sheng-Min
AU  - Wang SM
AUID- ORCID: 0000-0003-2521-1413
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
FAU - Kim, Nak-Young
AU  - Kim NY
AUID- ORCID: 0000-0003-0116-6283
AD  - Department of Psychiatry, Keyo Hospital, Uiwang, Korea.
FAU - Na, Hae-Ran
AU  - Na HR
AUID- ORCID: 0000-0002-7960-8603
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
FAU - Lim, Hyun Kook
AU  - Lim HK
AUID- ORCID: 0000-0001-8742-3409
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
FAU - Woo, Young Sup
AU  - Woo YS
AUID- ORCID: 0000-0002-0961-838X
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
FAU - Pae, Chi-Un
AU  - Pae CU
AUID- ORCID: 0000-0003-1632-4248
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
FAU - Bahk, Won-Myong
AU  - Bahk WM
AUID- ORCID: 0000-0002-0156-2510
AD  - Department of Psychiatry, College of Medicine, The Catholic University of Korea, 
      Seoul, Korea.
LA  - eng
PT  - Journal Article
PL  - Korea (South)
TA  - Clin Psychopharmacol Neurosci
JT  - Clinical psychopharmacology and neuroscience : the official scientific journal of 
      the Korean College of Neuropsychopharmacology
JID - 101207332
PMC - PMC8077059
OTO - NOTNLM
OT  - Depression
OT  - Esketamine
OT  - Meta-analysis.
OT  - Suicide
OT  - Treatment resistant depression
COIS- Conflicts of Interest No potential conflict of interest relevant to this article 
      was reported.
EDAT- 2021/04/24 06:00
MHDA- 2021/04/24 06:01
PMCR- 2021/05/31
CRDT- 2021/04/23 05:46
PHST- 2021/02/01 00:00 [received]
PHST- 2021/02/15 00:00 [revised]
PHST- 2021/02/17 00:00 [accepted]
PHST- 2021/04/23 05:46 [entrez]
PHST- 2021/04/24 06:00 [pubmed]
PHST- 2021/04/24 06:01 [medline]
PHST- 2021/05/31 00:00 [pmc-release]
AID - cpn.2021.19.2.341 [pii]
AID - cpn-19-2-341 [pii]
AID - 10.9758/cpn.2021.19.2.341 [doi]
PST - ppublish
SO  - Clin Psychopharmacol Neurosci. 2021 May 31;19(2):341-354. doi: 
      10.9758/cpn.2021.19.2.341.