Use of intranasal esketamine in the treatment of resistant depression: a literature review
DOI:
https://doi.org/10.33448/rsd-v11i16.38613Keywords:
Anesthetics ; Mental Disorders; Suicide.Abstract
Depression is the most prevalent psychiatric illness, caused by genetic, psychosocial and biological factors. The most influential pathophysiological hypothesis to explain depression is the monoaminergic theory, in which there are deficits in the transmission of monoamines. When it does not respond satisfactorily to typical initial treatments, we will be facing a picture of treatment-resistant depression, requiring the search for new therapeutic modalities. In view of the high rate of suicide attempts and the disability caused by the disease, a fast-acting drug with good potency is needed for greater effectiveness, the specialized literature has indicated ketamine as medication. This is an anesthetic drug approved in 1970, however, from 2000 it was recognized for its fast-acting antidepressant effects when administered intravenously at a dose of 0.5 mg/kg. Recently, intranasal esketamine (Spravato®) was approved for use in resistant depression. Therefore, through a bibliographic survey of scientific articles, this study aims to characterize the specificities of resistant depression, in addition to evaluating the challenges and perspectives of the use of intranasal esketamine. It was verified that it is a more practical, comfortable and fast option, however, its use presents mild to moderate dissociative side effects in most cases. In addition, its main disadvantage is the high cost, making it difficult to access the population. Therefore, conclusive studies on the long-term use of esketamine are still lacking.
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