When a depression drug made things worse
Paradoxical Depressive Response to Intranasal Esketamine in Treatment-Resistant Depression: A Case Series
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Two people with severe depression felt better at first after using a nasal spray called esketamine, but then got much sadder and thought about hurting themselves. When they stopped the spray, they felt better again.
Surprising Findings
Esketamine, approved for rapid suicide risk reduction, triggered suicidal ideation in two patients after initial improvement.
Esketamine is marketed as a suicide-prevention tool for treatment-resistant depression—this study shows it may, in rare cases, cause the very thing it’s meant to prevent.
Practical Takeaways
If you or someone you know is on esketamine and feels worse after a dose increase or after initial improvement, talk to your doctor immediately—discontinuation reversed symptoms in both cases.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
Two people with severe depression felt better at first after using a nasal spray called esketamine, but then got much sadder and thought about hurting themselves. When they stopped the spray, they felt better again.
Surprising Findings
Esketamine, approved for rapid suicide risk reduction, triggered suicidal ideation in two patients after initial improvement.
Esketamine is marketed as a suicide-prevention tool for treatment-resistant depression—this study shows it may, in rare cases, cause the very thing it’s meant to prevent.
Practical Takeaways
If you or someone you know is on esketamine and feels worse after a dose increase or after initial improvement, talk to your doctor immediately—discontinuation reversed symptoms in both cases.
Publication
Journal
The American Journal of Case Reports
Year
2024
Authors
J. A. Ontiveros-Sanchez de la Barquera, Luis Alberto De La Garza García, S. García, Guillermo Sánchez Torres, Grecia Alejandra Perez Jalomo
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Claims (5)
A nasal spray called esketamine can help people with severe depression that didn’t respond to other treatments, by fixing how brain cells talk to each other and helping them form better connections.
In two people with severe depression that didn’t improve with other treatments, their symptoms got worse when their esketamine nose spray was given twice a week instead of once a week.
Two people with severe depression that didn’t respond to other treatments felt better at first after using a nasal spray called esketamine, but then their depression and suicidal thoughts got much worse—until they stopped using the spray, and then they felt better again.
Two people with severe depression that didn’t respond to other treatments felt better and had fewer thoughts of suicide right after they stopped using a nasal spray called esketamine—even though they felt worse while using it.
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.