A Multi-Center, Open-Label, Single-Arm Study to Investigate the Early Effectiveness of Esketamine Nasal Spray in Patients with Treatment-Resistant Depression Using a Mobile Self-Monitoring Application.

In adults with treatment-resistant depression, esketamine nasal spray combined with daily self-monitoring through a mobile app produced significant reductions in depressive and anxiety symptoms as early as one day after the first dose. The open-label study enrolled 18-65 year olds who had failed at least two prior antidepressant therapies. Participants used the EsCARe app to track mood, sleep, and somatic symptoms alongside standard clinical assessments. By week 2, scores on the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale had notably decreased; the Hamilton Depression Rating Scale showed improvement by week 4. The mobile app reliably and validly tracked depressive symptoms, offering patients and clinicians immediate feedback on treatment effectiveness.

Study at a glance

Abstract

This study assesses the early effectiveness of esketamine nasal spray (ESK) in adults with treatment-resistant depression (TRD) 1 day after the first administration, as monitored through self-assessment via the mobile application, Esketamine Continuing Assessment for Relapse Prevention (EsCARe). In this multi-center, open-label, single-arm study, adults aged 18-65 years diagnosed with TRD after failing at least two antidepressant therapies were enrolled from five tertiary hospitals in South Korea. During the induction period, participants self-administered ESK twice weekly and used the EsCARe app daily to record mood, sleep, and somatic symptoms. Key clinical assessments, the Patient Health Questionnaire-9 (PHQ-9), the Hamilton Depression Rating Scale (HAMD), and the Generalized Anxiety Disorder Scale (GAD-7), were measured at baseline and at weeks 2 and 4. The reliability and validity of EsCARe was assessed. The treatment results indicated significant improvements in depressive and anxiety symptoms, with notable reductions in the PHQ-9 and the GAD-7 by week 2, and the HAMD by week 4. The EsCARe app reliably and validly monitored depressive symptoms and demonstrated a significant reduction in depressive symptoms 1 day after the first administration of ESK. Using ESK, complemented by mobile self-monitoring, effectively reduces the symptoms of TRD early in the treatment course. Integrating mobile health technology into the therapeutic regimen highlights a significant advancement in managing TRD, offering patients and clinicians immediate feedback on treatment efficacy.