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Real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report

BACKGROUND: Patients with depression who are treated with esketamine nasal spray may commonly experience dysgeusia (bad/metallic/bitter taste) and related side effects such as nausea and vomiting. While pretreatment with antiemetics can mitigate or prevent nausea and vomiting, it may not address dys...

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Autores principales: Bossaller, Nicholas A., Shelton, Richard C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045462/
https://www.ncbi.nlm.nih.gov/pubmed/32127908
http://dx.doi.org/10.1186/s12991-020-00262-x
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author Bossaller, Nicholas A.
Shelton, Richard C.
author_facet Bossaller, Nicholas A.
Shelton, Richard C.
author_sort Bossaller, Nicholas A.
collection PubMed
description BACKGROUND: Patients with depression who are treated with esketamine nasal spray may commonly experience dysgeusia (bad/metallic/bitter taste) and related side effects such as nausea and vomiting. While pretreatment with antiemetics can mitigate or prevent nausea and vomiting, it may not address dysgeusia as a contributing factor. Alternative interventions could help to manage vomiting due to dysgeusia following administration of esketamine nasal spray in those patients who are affected. CASE PRESENTATION: A 40-year-old man presented to the emergency department with depression and started treatment with an oral antidepressant. After providing informed consent to participate in a clinical trial evaluating the efficacy and safety of esketamine for major depressive disorder with active suicidal ideation with intent, he received 84 mg of esketamine nasal spray twice per week for 4 weeks. On the first 2 days of esketamine administration, the patient reported dysgeusia lasting several hours and intermittent retching lasting approximately 20 min. The patient was then given a fruit punch–flavored powdered drink (Crystal Light Fruit Punch™) approximately 25 min after nasal spray administration during the study period. The use of a fruit punch drink resulted in notable improvement of dysgeusia and associated vomiting, with time to resolution occurring within 30 min of the report of the adverse event. CONCLUSIONS: A fruit punch–flavored powdered drink mix taken shortly after administration of esketamine nasal spray may rapidly manage and prevent vomiting due to dysgeusia.
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spelling pubmed-70454622020-03-03 Real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report Bossaller, Nicholas A. Shelton, Richard C. Ann Gen Psychiatry Case Report BACKGROUND: Patients with depression who are treated with esketamine nasal spray may commonly experience dysgeusia (bad/metallic/bitter taste) and related side effects such as nausea and vomiting. While pretreatment with antiemetics can mitigate or prevent nausea and vomiting, it may not address dysgeusia as a contributing factor. Alternative interventions could help to manage vomiting due to dysgeusia following administration of esketamine nasal spray in those patients who are affected. CASE PRESENTATION: A 40-year-old man presented to the emergency department with depression and started treatment with an oral antidepressant. After providing informed consent to participate in a clinical trial evaluating the efficacy and safety of esketamine for major depressive disorder with active suicidal ideation with intent, he received 84 mg of esketamine nasal spray twice per week for 4 weeks. On the first 2 days of esketamine administration, the patient reported dysgeusia lasting several hours and intermittent retching lasting approximately 20 min. The patient was then given a fruit punch–flavored powdered drink (Crystal Light Fruit Punch™) approximately 25 min after nasal spray administration during the study period. The use of a fruit punch drink resulted in notable improvement of dysgeusia and associated vomiting, with time to resolution occurring within 30 min of the report of the adverse event. CONCLUSIONS: A fruit punch–flavored powdered drink mix taken shortly after administration of esketamine nasal spray may rapidly manage and prevent vomiting due to dysgeusia. BioMed Central 2020-02-26 /pmc/articles/PMC7045462/ /pubmed/32127908 http://dx.doi.org/10.1186/s12991-020-00262-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Bossaller, Nicholas A.
Shelton, Richard C.
Real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report
title Real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report
title_full Real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report
title_fullStr Real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report
title_full_unstemmed Real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report
title_short Real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report
title_sort real-world approach to managing dysgeusia following the use of esketamine nasal spray: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045462/
https://www.ncbi.nlm.nih.gov/pubmed/32127908
http://dx.doi.org/10.1186/s12991-020-00262-x
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