The study, published in The American Journal of Psychiatry, compared an intranasal formulation of esketamine, part of the ketamine molecule, to a placebo for rapid treatment of symptoms of major depression, including suicidality, among individuals at imminent suicide risk. The researchers at the Yale School of Medicine in the US involved 68 participants randomly assigned to one of two groups - either receiving esketamine or placebo twice a week for four weeks alongside standard treatment with antidepressants. They looked at effects at four hours after first treatment, at 24 hours and at 25 days.
Researchers, including those from Janssen Research and Development, found a significant improvement in depression scores and decreased suicidal ideation in the esketamine group compared to the placebo group at four hours and at 24 hours.
The esketamine effects were not greater than the placebo at 25 days. The measurement of suicide risk took into consideration both the patient's and clinician's perspectives.
The results of the study support nasal spray esketamine as a possible effective rapid treatment for depressive symptoms in patients assessed to be at imminent risk for suicide, researchers said.
Esketamine could be an important treatment to bridge the gap that exists because of the delayed effect of most common antidepressants. Most antidepressants take four to six weeks to become fully effective. The scientists caution that more research is needed on the potential for abuse of ketamine.