Research Confirms Effectiveness of Esketamine Nasal Spray For Treatment-Resistant Depression Patients

Esketamine Nasal Spray

A recent study has yielded promising results, suggesting that flexibly dosed esketamine nasal spray can provide lasting relief for adults grappling with treatment-resistant depression (TRD), with improvements observed over a remarkable span of up to 6.5 years.

The study findings were unveiled during a poster presentation at the esteemed Psych Congress 2023.

“Long-Term Efficacy of Esketamine Nasal Spray Dosed in Accordance With US Prescribing Information in Adults With Treatment-Resistant Depression: A Subgroup Analysis of the SUSTAIN-3 Study Up to 6.5 Years,”  was the presentation that shared insights from the SUSTAIN-3 clinical trial.

Study To Understand The Effectiveness Of Esketamine Nasal Spray

The primary objective of the SUSTAIN-3 study is to evaluate the overall tolerability and safety of esketamine nasal spray in individuals grappling with TRD. The trial unfolds over two distinct phases: a 4-week induction phase and a variable-duration optimization and maintenance phase.

To unpack the details of the subgroup analysis presented in this poster, researchers directed their focus squarely on the long-term efficacy of esketamine nasal spray in adults diagnosed with TRD.

The efficacy data was drawn from the broader SUSTAIN-3 study, which tapped into the experiences of 1021 adults aged 18 to 64, all of whom had previously participated in one of five esketamine nasal spray “parent” studies before transitioning to the SUSTAIN-3 study.

Impressively, these patients had been receiving esketamine nasal spray treatment for a median duration of 46.9 months.

In the subgroup analysis, patients were administered esketamine nasal spray at doses of either 56 mg or 84 mg twice a week during the induction phase. During the optimization and maintenance phase that followed, they received flexibly dosed esketamine nasal spray in conjunction with an oral antidepressant.

The researchers assessed the severity of the patients’ conditions using both clinician- and patient-reported measures, employing the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Patient Health Questionnaire 9-Item (PHQ-9).

At the outset of the induction phase, the mean baseline MADRS score stood at 29.1, while the PHQ-9 score was 15.4. These figures indicate the presence of moderate to severe depression.

Importantly, these gains in mental health were sustained throughout the optimization and maintenance phase.

Perhaps the most promising revelation from the study was the percentage of patients who achieved MADRS and PHQ-9 remission. Remission, in this context, was defined as scores below 12 for MADRS and below 5 for PHQ-9.

The data revealed that, at the time of their last assessment during the optimization and maintenance phase, a significant 49.6% of patients had achieved MADRS remission, while 33.6% had attained PHQ-9 remission.

In summary, the investigators concluded that “this subgroup analysis demonstrates that in adults with TRD, improvements in depressive symptoms with flexibly dosed [esketamine nasal spray] appear to be maintained with long-term treatment (up to 6.5 years).”

This study brings a glimmer of hope to individuals grappling with TRD, highlighting the potential for long-lasting relief through the use of esketamine nasal spray.

The sustained improvements in depressive symptoms observed over an extended period offer a promising avenue for those who have struggled to find effective treatments for their condition.

It underscores the importance of continued research and the potential for innovative therapies to transform the lives of individuals living with treatment-resistant depression.

The findings offer a ray of hope and optimism for the future of mental health treatment, with esketamine nasal spray emerging as a beacon of progress in the field.


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  • Research Confirms Effectiveness of Esketamine Nasal Spray For Treatment-Resistant Depression Patients