This was the result of a clinical study involving the Vienna University Hospital (AKH), which was published last Thursday in the “New England Journal of Medicine”.
The results of the scientific study led by Andreas Reif, director of the Clinic for Psychiatry in Frankfurt, and co-authored by the Viennese psychiatrist Richard Frey (University Clinic for Psychiatry/MedUni Vienna, AKH) are currently also being presented at the annual meeting of the European College of Neuropsychopharmacology presented in Barcelona.
320 million people depressed
The background: around 320 million people worldwide are likely to be depressed. In Austria, the frequency is reported to be slightly less than eight percent of the population. The number of unreported cases is high. The conventional antidepressants – especially so-called serotonin and/or norepinephrine reuptake inhibitors (SSRI or SNRI) – which increase the concentration of the nerve messengers serotonin and/or norepinephrine in the synaptic gap between nerve cells in the brain, only develop after around two weeks Effect.
But the biggest shortcoming is that around two thirds of all patients with major depression do not respond to the first attempt at conventional drug therapy. In a third, a second treatment attempt with the medication remains unsuccessful. Until recently, the main treatment option for these people was the additional administration of an atypical antipsychotic (e.g. quetiapine). Since 2019, esketamine, which is derived from the anesthetic ketamine, has also been approved in the EU as a nasal spray for the treatment of “resistant” depression.
The psychiatrists from 171 hospitals in 24 countries involved in the scientific study conducted an initial comparative study between the two strategies. “The patients were between 18 and 74 years old. On average, they had been in their current major depressive episode for more than 60 weeks. Symptoms had not improved significantly with treatment with an SSRI or SNRI.
“For two thirds of the patients, it was already the third attempt at treatment,” wrote the German Medical Journal about the scientific study. The third third of the total of 676 test subjects had already attempted up to six different treatment attempts. The patients were between 18 and 74 years old and had suffered from major depression for at least 60 weeks.
In a ratio of one to one, the patients continued to take the conventional medications over the course of the study and also used the antipsychotic quetiapine (340 subjects) or the esketamine nasal spray (336 subjects). According to the scientists, the results speak in favor of the nasal spray. “More patients in the esketamine group than in the quetiapine group showed remission (disappearance of symptoms; note) after eight weeks (91 of 336 patients or 27.1 percent versus 60 of 340 patients or 17.6 percent).” , says the New England Journal of Medicine (DOI: 10.1056/NEJMoa2304145).
The effect apparently increased with the duration of treatment. “At week 32, 49 percent of patients in the esketamine group and 33 percent in the quetiapine group were in remission,” wrote the German medical journal. A possible problem with esketamine therapy is that patients usually have to come to a clinic once a week.
ePaper
Read the ePaper now!
Read the daily ePaper edition of the OÖNachrichten – browse through it digitally now!
to the e-paper
info By clicking on the icon you can add the keyword to your topics.
info By clicking on the icon you open your “my topics” page. You have saved 15 tags and need to remove tags.
info By clicking on the icon you can remove the keyword from your topics.
Add the topic to your topics.