PMID- 35873243 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220726 IS - 1664-0640 (Print) IS - 1664-0640 (Electronic) IS - 1664-0640 (Linking) VI - 13 DP - 2022 TI - Efficacy and Safety of Intranasal Esketamine in Patients With Treatment-Resistant Depression and Comorbid Chronic Post-traumatic Stress Disorder: Open-Label Single-Arm Pilot Study. PG - 865466 LID - 10.3389/fpsyt.2022.865466 [doi] LID - 865466 AB - INTRODUCTION: Major depressive disorder (MDD) is more likely to resist to usual treatment when it is associated with post-traumatic stress disorder (PTSD). Capitalizing on the effect of ketamine in both treatment-resistant depression (TRD) and PTSD, we conducted a study in order to assess the efficacy of intranasal (IN) Esketamine in patients having TRD with comorbid PTSD. MATERIALS AND METHODS: In this open-label, single arm, retrospective pilot study, 11 patients were treated with IN Esketamine (56 or 84 mg) with a longitudinal follow-up of 6 months. IN Esketamine was administered twice weekly during the first month, once weekly during the second month, and then once every 1 or 2 weeks. Patients were assessed with Montgomery-Asberg Depression Rating Scale (MADRS), Patient Health Questionnaire 9 items, Global Assessment of Functioning (GAF), and Clinical Global Impression-Suicide Scale (CGI-SS). RESULTS: We included 9 women and 2 men (mean age 47.3 +/- 11.1 years). The mean (SD) MADRS scores decreased significantly from 38.6 (6.4) at baseline to 18.2 (10.03) after 6 months of IN Esketamine; 7 patients were responders and 3 patients were in remission. The percentage of patients who were moderately to severely suicidal declined from 63.6% at baseline to 27.3% after 1 month of IN Esketamine sessions. No serious adverse reactions were observed. CONCLUSION: This study reports the outcomes of 11 severely ill patients with comorbid TRD and PTSD after IN Esketamine treatment. Esketamine significantly improved depression symptoms, suggesting that it is likely to be a treatment of choice in this specific population. CI - Copyright (c) 2022 Rotharmel, Benosman, El-Hage, Berjamin, Ribayrol, Guillin, Gaillard, Berkovitch and Moulier. FAU - Rotharmel, Maud AU - Rotharmel M AD - Service Hospitalo-Universitaire de Psychiatrie, Centre d'Excellence Therapeutique-Institut de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville-les-Rouen, France. FAU - Benosman, Cherifa AU - Benosman C AD - Service Hospitalo-Universitaire de Psychiatrie, Centre d'Excellence Therapeutique-Institut de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville-les-Rouen, France. FAU - El-Hage, Wissam AU - El-Hage W AD - Centre Regional de Psychotraumatologie, Centre Hospitalier Regional Universitaire (CHRU) de Tours, Tours, France. AD - INSERM U1253 Imagerie et Cerveau (iBrain), Tours, France. FAU - Berjamin, Caroline AU - Berjamin C AD - Service Hospitalo-Universitaire de Psychiatrie, Centre d'Excellence Therapeutique-Institut de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville-les-Rouen, France. FAU - Ribayrol, Diane AU - Ribayrol D AD - Service Hospitalo-Universitaire de Psychiatrie, Centre d'Excellence Therapeutique-Institut de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville-les-Rouen, France. FAU - Guillin, Olivier AU - Guillin O AD - Service Hospitalo-Universitaire de Psychiatrie, Centre d'Excellence Therapeutique-Institut de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville-les-Rouen, France. AD - Centre Hospitalier Universitaire (CHU) de Rouen, Rouen, France. AD - Faculte de Medecine, Normandy University, Rouen, France. FAU - Gaillard, Raphael AU - Gaillard R AD - Service Hospitalo-Universitaire, Pole Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France. FAU - Berkovitch, Lucie AU - Berkovitch L AD - Service Hospitalo-Universitaire, Pole Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France. AD - Universite Paris Cite, Paris, France. FAU - Moulier, Virginie AU - Moulier V AD - Service Hospitalo-Universitaire de Psychiatrie, Centre d'Excellence Therapeutique-Institut de Psychiatrie, Centre Hospitalier du Rouvray, Sotteville-les-Rouen, France. AD - Unite de Recherche Clinique (URC), EPS Ville Evrard, Neuilly-sur-Marne, France. LA - eng PT - Journal Article DEP - 20220708 PL - Switzerland TA - Front Psychiatry JT - Frontiers in psychiatry JID - 101545006 PMC - PMC9305073 OTO - NOTNLM OT - Esketamine OT - assisted-therapy OT - post-traumatic stress disorder OT - trauma-focused psychotherapy OT - treatment-resistant depression COIS- MR has received honoraria or consulting fees from Janssen-Cilag and Lundbeck-Otsuka. WE-H reports personal fees from Air Liquide, Chugai, Lundbeck, Janssen-Cilag, Otsuka, and UCB. LB has participated to a Medical Education Steering Committee for Janssen-Cilag. OG has received honoraria or consulting fees from EISAI, Lundbeck, Otsuka/Lundbeck, Janssen-Cilag, MAGPREP, and Bioprojet. RG has received compensation as a member of the scientific advisory board of Janssen, Lundbeck, Roche, SOBI, and Takeda. He has consulted and/or served as speaker for Astra Zeneca, Boehringer-Ingelheim, Pierre Fabre, Lilly, Lundbeck, MAPREG, Otsuka, Pileje, SANOFI, Servier, LVMH, and has received research support from Servier. Co-founder and stock shareholder: Regstem. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/07/26 06:00 MHDA- 2022/07/26 06:01 PMCR- 2022/07/08 CRDT- 2022/07/25 03:33 PHST- 2022/01/29 00:00 [received] PHST- 2022/06/20 00:00 [accepted] PHST- 2022/07/25 03:33 [entrez] PHST- 2022/07/26 06:00 [pubmed] PHST- 2022/07/26 06:01 [medline] PHST- 2022/07/08 00:00 [pmc-release] AID - 10.3389/fpsyt.2022.865466 [doi] PST - epublish SO - Front Psychiatry. 2022 Jul 8;13:865466. doi: 10.3389/fpsyt.2022.865466. eCollection 2022.