Esketamine Treatment for Depression in Adults: A PRISMA Systematic Review and Meta-Analysis.
Objective: Intranasal esketamine has been approved as an adjunctive therapy for treatment-resistant major depressive disorder with acute suicidal ideation and behavior. The authors conducted a systematic review and meta-analysis of the available data on its efficacy against depression and suicidalit...
| Publicado en: | American Journal of Psychiatry Vol. 182; no. 3; pp. 259 - 276 |
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| Autores principales: | , , |
| Formato: | Artículo |
| Publicado: |
American Psychiatric Publishing, Inc.
Mar2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=183369456&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 183369456 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 0002953X API jtl: American Journal of Psychiatry issn: 0002953X maglogo: N pubinfo: dt: Mar2025 vid: 182 iid: 3 pid: 37323 pub: American Psychiatric Publishing, Inc. artinfo: ui: 183369456 10.1176/appi.ajp.20240515 ppf: 259 ppct: 17 formats: tig: atl: Esketamine Treatment for Depression in Adults: A PRISMA Systematic Review and Meta-Analysis. aug: au: Fountoulakis, Konstantinos N. Saitis, Athanasios Schatzberg, Alan F. affil: 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece Stanford University Mood Disorders Center and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford. su: Mental depression Suicidal behavior Suicidal ideation Electronic data processing Keyword searching sug: subj: Mental depression Suicidal behavior Suicidal ideation Electronic data processing Data Processing, Hosting, and Related Services Keyword searching keyword: Depressive Disorders Ketamine/Esketamine Meta-Analysis Suicidality Treatment-Resistant Depression Depressive Disorders Ketamine/Esketamine Meta-Analysis Suicidality Treatment-Resistant Depression ab: Objective: Intranasal esketamine has been approved as an adjunctive therapy for treatment-resistant major depressive disorder with acute suicidal ideation and behavior. The authors conducted a systematic review and meta-analysis of the available data on its efficacy against depression and suicidality as well as its side effects. Methods: MEDLINE was searched with the keyword "esketamine" on March 24, 2024, using the PRISMA method. Data processing and statistical analysis were performed with R, version 4.3.3, and the meta-analysis was performed with the METAFOR package. Results: Of 1,115 articles initially identified, 87 were included for analysis and discussion. At weeks 2–4, randomized controlled trials were mostly negative or failed; however, the meta-analysis returned a weak but significant positive effect for depression (effect size range, 0.15–0.23 at weeks 2–4), similar to augmentation strategies with atypical antipsychotics for treatment-resistant depression. The effect size concerning suicidality was not significant at any time point. The sensitivity analysis produced the same results. Conclusions: The study findings suggest that esketamine's efficacy as an add-on to antidepressants is modest in treatment-resistant depression (similar to augmentation strategies with atypical antipsychotics) and is absent against suicidality itself. These findings need to be considered in light of esketamine's abuse potential and the fact that long-term effects are still not fully known. Some alarming signs concerning deaths and emerging suicidality during the testing phase are discussed, along with other regulatory issues. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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