In two people with severe depression that didn’t respond to other treatments, a nasal spray called esketamine made them feel better at first, but then their mood got worse again—like a quick high followed by a crash.
Claim Language
Language Strength
probability
Uses probability language (may, likely, can)
The claim uses 'suggesting a possible biphasic response pattern,' which indicates uncertainty and likelihood rather than certainty. Words like 'possible' and 'suggesting' signal probabilistic language, not definitive causation.
Context Details
Domain
medicine
Population
human
Subject
Two patients with treatment-resistant depression
Action
was associated with
Target
an initial improvement in depressive symptoms and suicidal ideation followed by subsequent deterioration
Intervention Details
Gold Standard Evidence Needed
According to GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this specific claim, ordered from strongest to weakest evidence.
Evidence from Studies
Supporting (1)
Paradoxical Depressive Response to Intranasal Esketamine in Treatment-Resistant Depression: A Case Series
Two people with severe depression took a nasal spray called esketamine, and at first they felt better, but then they felt worse — even more depressed and suicidal. When they stopped the spray, they got better again. This matches exactly what the claim says.