Observational · 2025
Esketamine nasal spray and quality of life in 18 people with treatment-resistant depression
- Original title
- Esketamine and Quality of Life Improvement in Treatment-Resistant Depression Patients: A Real-World Clinical Study.
- Authors
- Lupi M, Carano A, Acciavatti T, et al.
- Journal
- Journal of clinical psychopharmacology, 2025
- Molecules
- Esketamine
- Conditions
- Treatment-resistant depression
- Participants
- 18
- Evidence grade
- Very low
- Source
- Read the original paper
The question
Does esketamine nasal spray, added to an oral antidepressant, improve day-to-day quality of life and functioning in adults whose depression has not responded to previous treatments?
What they did
Researchers followed 18 adults with treatment-resistant depression at several clinics in an observational study, meaning no one was randomly assigned and there was no placebo group. All received esketamine nasal spray alongside an oral antidepressant. Questionnaires on quality of life, disability, social functioning and depression severity were completed at the start and again at 1, 3 and 6 months.
What they found
Scores on all three quality-of-life and functioning measures (the Q-LES-Q-SF, the Sheehan Disability Scale and the Personal and Social Performance Scale) improved significantly, with gains building over the 1, 3 and 6 month check-ins. Average depression scores on the MADRS fell from 39.2 at the start to 28.7 at 1 month, 20.9 at 3 months and 15.9 at 6 months. At 6 months, changes in depression scores tracked with changes in quality of life and disability, but not with the social performance measure.
The fine print
Only 18 people took part, and there was no control or placebo group, so improvement over time cannot be attributed to esketamine with confidence. Participants and clinicians knew what treatment was being given, and most outcomes were self-reported. The abstract does not report side effects or dropouts, and this summary is based on the abstract alone.
What it means
In this small real-world group, people taking esketamine nasal spray with an antidepressant reported better quality of life and functioning over six months, but the study design cannot show that the medication caused the change.
Evidence grade: Very low. A small, uncontrolled real-world study of 18 people with no comparison group or blinding, so improvements cannot be separated from other influences.
This summary is based on the study’s published abstract.