Intranasal Esketamine (Spravato™) for Use in Treatment-Resistant Depression In Conjunction With an Oral Antidepressant

Major depressive disorder (MDD) affects more than 16 million adults each year in the United States. 1 The incomplete response that many persons experience with current antidepressant (AD) therapies is one factor contributing to the difficulty of successfully treating MDD. 2 Approximately 30% of patients meet the criteria for treatment-resistant depression (TRD), having no positive therapeutic response even after trying two or more AD medications. 2 According to the World Health Organization (WHO), depression is the leading cause of disability worldwide. 3 Untreated depression is a major risk factor for suicide: Each year, approximately 800,000 people–– one person every 40 seconds––successfully complete suicide. 4 , 5 Many patients with MDD are at risk for poor outcomes because of the limitations of currently approved treatments. 6 These incomplete or poor responses to traditional ADs have led to the off-label use of many novel substances for the treatment of MDD.