Clinical case analysis of dissociative symptoms caused by esketamine hydrochloride nasal spray in treatment of treatment-resistant depression
10.3760/cma.j.cn114015-20250303-00110
- VernacularTitle:盐酸艾司氯胺酮鼻喷剂在治疗难治性抑郁症中导致分离症状的临床病例分析
- Author:
Qiying DENG
1
;
Shanshan TIAN
;
Tingfang WU
;
Anning LI
;
Fengrong AN
;
Gang WANG
Author Information
1. 首都医科大学附属北京安定医院Ⅰ期病房，北京 100088
- Publication Type:Journal Article
- Keywords:
Depressive disorder, major;
Depressive disorder, treatment-resistant;
Anxiety, dissociative symptoms;
Drug-related side effects and adverse reactions;
Esk
- From:
Adverse Drug Reactions Journal
2025;27(5):296-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of dissociative symptoms induced by esketamine hydrochloride nasal spray in patients with treatment-resistant depression (TRD).Methods:The medical records of patients in phase Ⅲ clinical trials for the treatment of TRD who received esketamine hydrochloride nasal spray in Beijing Anding Hospital, Capital Medical University from June 2018 to February 2021 were collected. The general situation of patients (age, gender, comorbid diseases, etc.), the medication of esketamine hydrochloride nasal spray, the combined use of antidepressants, the time from medication to the occurrence of dissociative symptoms each time, duration, severity, evaluation results of causal relationship with esketamine application, intervention and prognosis were recorded, and a retrospective descriptive statistical analysis was performed.Results:A total of 21 patients with TRD were enrolled in the study, including 17 (81.0%) with dissociative symptoms, 10 males and 7 females; the age ranged from 20 to 53 years, with a median age of 36 years. All patients were treated with esketamine hydrochloride by nasal spray. The first dose was 56 mg, and the other seven doses were 56 mg or 84 mg, twice a week, lasting for 4 weeks. The 17 patients were all given combination treatment with oral antidepressants. A total of 88 times of dissociative symptoms occurred in the 17 patients. The time from medication to the onset of dissociative symptoms ranged from 4 to 128 min, with a median time of 15 min. The duration of dissociative symptoms ranged from 12 to 326 minutes, with a median time of 70 minutes. The dissociative symptoms were mostly mild. The causal relationship analysis between the esketamine hydrochloride nasal spray and the dissociative symptoms showed that it was definitely related in 6 cases, probably in 1 case, and possibly in 10 cases. The dissociative symptoms in all patients were subsided without intervention.Conclusions:Esketamine hydrochloride nasal spray can cause dissociative symptoms in patients with TRD, most of which occur within 30 minutes after the treatment. The duration of symptoms in most patients is less than 120 minutes, most of which are mild and can subside on their own, and the prognosis is good.
