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Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression

BACKGROUND: Patients with anxious major depressive disorder (MDD) are more likely to have poorer outcomes than those with non-anxious MDD. However, the effect of esketamine on adolescents with anxious versus non-anxious MDD has remained unknown. AIMS: We compared the efficacy of esketamine in adoles...

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Autores principales: Lan, Xiaofeng, Wang, Chengyu, Zhang, Fan, Liu, Haiyan, Fu, Ling, Li, Weicheng, Ye, Yanxiang, Hu, Zhibo, Mai, Siming, Ning, Yuping, Zhou, Yanling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314616/
https://www.ncbi.nlm.nih.gov/pubmed/37396782
http://dx.doi.org/10.1136/gpsych-2023-101007
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author Lan, Xiaofeng
Wang, Chengyu
Zhang, Fan
Liu, Haiyan
Fu, Ling
Li, Weicheng
Ye, Yanxiang
Hu, Zhibo
Mai, Siming
Ning, Yuping
Zhou, Yanling
author_facet Lan, Xiaofeng
Wang, Chengyu
Zhang, Fan
Liu, Haiyan
Fu, Ling
Li, Weicheng
Ye, Yanxiang
Hu, Zhibo
Mai, Siming
Ning, Yuping
Zhou, Yanling
author_sort Lan, Xiaofeng
collection PubMed
description BACKGROUND: Patients with anxious major depressive disorder (MDD) are more likely to have poorer outcomes than those with non-anxious MDD. However, the effect of esketamine on adolescents with anxious versus non-anxious MDD has remained unknown. AIMS: We compared the efficacy of esketamine in adolescents with MDD and suicidal ideation, both anxious and non-anxious. METHODS: Fifty-four adolescents with anxious (n=33) and non-anxious (n=21) MDD received three infusions of esketamine 0.25 mg/kg or active-placebo (midazolam 0.045 mg/kg) over 5 days, with routine inpatient care and treatment. Suicidal ideation and depressive symptoms were assessed using the Columbia Suicide Severity Rating Scale and the Montgomery-Åsberg Depression Rating Scale. Multiple-sample proportional tests were used to compare the differences between groups on treatment outcomes 24 hours after the final infusion (day 6, primacy efficacy endpoint) and throughout the 4-week post-treatment (days 12, 19 and 33). RESULTS: In subjects who received esketamine, a greater number of patients in the non-anxious group than the anxious group achieved antisuicidal remission on day 6 (72.7% vs 18.8%, p=0.015) and day 12 (90.9% vs 43.8%, p=0.013), and the non-anxious group had a higher antidepressant remission rate compared with the anxious group on day 33 (72.7% vs 26.7%, p=0.045). No significant differences in treatment outcomes were observed between the anxious and non-anxious groups at other time points. CONCLUSIONS: Three infusions of esketamine as an adjunct to routine inpatient care and treatment had a greater immediate post-treatment antisuicidal effect in adolescents with non-anxious MDD than in those with anxious MDD; however, this benefit was temporary and was not maintained over time. TRIAL REGISTRATION NUMBER: ChiCTR2000041232.
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spelling pubmed-103146162023-07-02 Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression Lan, Xiaofeng Wang, Chengyu Zhang, Fan Liu, Haiyan Fu, Ling Li, Weicheng Ye, Yanxiang Hu, Zhibo Mai, Siming Ning, Yuping Zhou, Yanling Gen Psychiatr Original Research BACKGROUND: Patients with anxious major depressive disorder (MDD) are more likely to have poorer outcomes than those with non-anxious MDD. However, the effect of esketamine on adolescents with anxious versus non-anxious MDD has remained unknown. AIMS: We compared the efficacy of esketamine in adolescents with MDD and suicidal ideation, both anxious and non-anxious. METHODS: Fifty-four adolescents with anxious (n=33) and non-anxious (n=21) MDD received three infusions of esketamine 0.25 mg/kg or active-placebo (midazolam 0.045 mg/kg) over 5 days, with routine inpatient care and treatment. Suicidal ideation and depressive symptoms were assessed using the Columbia Suicide Severity Rating Scale and the Montgomery-Åsberg Depression Rating Scale. Multiple-sample proportional tests were used to compare the differences between groups on treatment outcomes 24 hours after the final infusion (day 6, primacy efficacy endpoint) and throughout the 4-week post-treatment (days 12, 19 and 33). RESULTS: In subjects who received esketamine, a greater number of patients in the non-anxious group than the anxious group achieved antisuicidal remission on day 6 (72.7% vs 18.8%, p=0.015) and day 12 (90.9% vs 43.8%, p=0.013), and the non-anxious group had a higher antidepressant remission rate compared with the anxious group on day 33 (72.7% vs 26.7%, p=0.045). No significant differences in treatment outcomes were observed between the anxious and non-anxious groups at other time points. CONCLUSIONS: Three infusions of esketamine as an adjunct to routine inpatient care and treatment had a greater immediate post-treatment antisuicidal effect in adolescents with non-anxious MDD than in those with anxious MDD; however, this benefit was temporary and was not maintained over time. TRIAL REGISTRATION NUMBER: ChiCTR2000041232. BMJ Publishing Group 2023-06-21 /pmc/articles/PMC10314616/ /pubmed/37396782 http://dx.doi.org/10.1136/gpsych-2023-101007 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Lan, Xiaofeng
Wang, Chengyu
Zhang, Fan
Liu, Haiyan
Fu, Ling
Li, Weicheng
Ye, Yanxiang
Hu, Zhibo
Mai, Siming
Ning, Yuping
Zhou, Yanling
Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression
title Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression
title_full Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression
title_fullStr Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression
title_full_unstemmed Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression
title_short Efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression
title_sort efficacy of repeated intravenous esketamine in adolescents with anxious versus non-anxious depression
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314616/
https://www.ncbi.nlm.nih.gov/pubmed/37396782
http://dx.doi.org/10.1136/gpsych-2023-101007
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