Aportación de esketamina intranasal (Spravato®) en el tratamiento de la depresión mayor resistente

Abstract

Classically, the pharmacological treatment of depression has been carried out with monoaminergic antidepressants, which present a series of limitations, such as a slow onset of action, an inadequate antidepressant response, sexual dysfunction or a tolerability that can be improved. The «glutamatergic hypothesis of depression» has been working for more than 3 decades and finally seems to have given results: esketamine, an isomer of ketamine, has shown, thanks to a robust clinical development program, that it is an fast-acting antidepressant, effective in resistant depression, with an acceptable tolerability, which has motivated its authorization in resistant depression in association with conventional antidepressants. Esketamine is the therapeutic answer to the glutamatergic hypothesis of depression.Additionally, the intranasal esketamine treatment in combination with an oral antidepressant was shown to be effective and safe in patients with treatment-resistant depression. The safety results were consistent in all the studies, without there being any unexpected adverse effects in the long-term