Exploring the role of Esketamine nasal spray in treatment-resistant depression

Abstract

Esketamine nasal spray is now a revolutionary drug in treating patients with treatment-resistant depression (TRD), exhibiting a rapid and strong response to depressive symptoms. In contrast to traditional antidepressants, which mainly affect the monoaminergic pathway, esketamine is an N-methyl-D-aspartate (NMDA) receptor antagonist and causes fast adjustment of glutamatergic neurotransmission. The main aim of the current review was to discover the evidence that can potentially prove the utility of esketamine in patients with a diagnosis of TRD and the information concerning its potential side effects in the short-term and in the long-term. This review also provides a summary of the available evidence on the pharmacology, clinical effectiveness, safety profile, and therapeutic usefulness of intranasal esketamine in TRD. The results point to esketamine nasal spray as an effective, but closely monitored, approach to the treatment of resistant depression.