{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:23:34Z","timestamp":1787657014933,"version":"build-2736575974"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neuropsychiatr"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Depressive symptoms and suicidality are highly prevalent in adolescents with early-onset psychosis (EOP) and often remain refractory to standard treatment. While S\u2011ketamine is an established treatment for treatment-resistant depression in adults (TRD), its use in primary psychotic disorders remains scarce due to risk of exacerbation of psychotic symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We present the case of a\u00a016-year-old male with schizophrenia (ICD-10: F20.9) and chronic suicidality. Despite achieving remission of positive symptoms with amisulpride, severe depressive symptoms including suicidality persisted. Following the initiation of off-label intranasal S\u2011ketamine (titrated to 84\u202fmg) at age\u00a017 and\u00a011\u00a0months, the patient showed a\u00a0rapid clinical response. The Montgomery\u2013\u00c5sberg Depression Rating Scale (MADRS) score decreased by 50% within 3\u00a0weeks, accompanied by a\u00a0significant reduction in the Positive and Negative Syndrome Scale (PANSS)\u2013positive symptoms subscale score (from 22\u00a0to\u00a010) and the PANSS\u2013negative symptoms subscale score (from 33\u00a0to\u00a017). Notably, no exacerbation of remitted positive symptoms occurred, and sustained functional recovery was achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case suggests that intranasal S\u2011ketamine may be a\u00a0safe and effective augmentation strategy for TRD and suicidality in stable adolescent early-onset psychosis, highlighting the need for further research in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40211-026-00587-1","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:08:09Z","timestamp":1787656089000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Case report of S-ketamine as treatment option for suicidal ideation and treatment-resistant depression in adolescents with early-onset psychosis","Fallbericht zu S-Ketamin als Behandlungsoption bei Selbstmordgedanken und therapierefrakt\u00e4rer Depression bei Jugendlichen mit fr\u00fch beginnender Psychose"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2688-0224","authenticated-orcid":false,"given":"Nicolas","family":"Schmelzle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Neubacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L.","family":"Plener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Scharinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"2","key":"587_CR1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1001\/JAMAPSYCHIATRY.2019.3360","volume":"77","author":"RA McCutcheon","year":"2020","unstructured":"McCutcheon\u00a0RA, Reis Marques\u00a0T, Howes\u00a0OD. Schizophrenia - An Overview. JAMA Psychiatry. 2020;77(2):201\u201310. https:\/\/doi.org\/10.1001\/JAMAPSYCHIATRY.2019.3360.","journal-title":"JAMA Psychiatry"},{"issue":"1","key":"587_CR2","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1192\/bjp.2022.203","volume":"223","author":"G Salazar De Pablo","year":"2023","unstructured":"Salazar De Pablo\u00a0G, Catalan\u00a0A, Vaquerizo Serrano\u00a0J, Pedruzo\u00a0B, Alameda\u00a0L, Sandroni\u00a0V, et\u00a0al. Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis. Br J Psychiatry. 2023;223(1):282\u201394.https:\/\/doi.org\/10.1192\/bjp.2022.203.","journal-title":"British Journal of Psychiatry"},{"key":"587_CR3","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.schres.2023.07.010","volume":"258","author":"SR Marder","year":"2023","unstructured":"Marder\u00a0SR, Umbricht\u00a0D. Negative symptoms in schizophrenia: Newly emerging measurements, pathways, and treatments. Schizophr Res. 2023;258:71\u20137.\u00a0https:\/\/doi.org\/10.1016\/j.schres.2023.07.010.","journal-title":"Schizophrenia Research"},{"issue":"1","key":"587_CR4","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1038\/s41398-021-01671-6","volume":"11","author":"W Bai","year":"2021","unstructured":"Bai\u00a0W, Liu\u00a0ZH, Jiang\u00a0YY, Zhang\u00a0QE, Rao\u00a0WW, Cheung\u00a0T, et\u00a0al. Worldwide prevalence of suicidal ideation and suicide plan among people with schizophrenia: a meta-analysis and systematic review of epidemiological surveys. Transl Psychiatry. 2021;11(1):552. https:\/\/doi.org\/10.1038\/s41398-021-01671-6.","journal-title":"Translational Psychiatry"},{"issue":"2","key":"587_CR5","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s00228-023-03605-1","volume":"80","author":"YT Wang","year":"2024","unstructured":"Wang\u00a0YT, Wang\u00a0XLe, Lei\u00a0L, Guo\u00a0ZY, Kan\u00a0FF, Hu\u00a0D, et\u00a0al. A systematic review and meta-analysis of the efficacy of ketamine and esketamine on suicidal ideation in treatment-resistant depression. Eur J Clin Pharmacol. 2024;80(2):287\u201396. https:\/\/doi.org\/10.1007\/s00228-023-03605-1.","journal-title":"Eur J Clin Pharmacol"},{"issue":"6","key":"587_CR6","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2025.10830","volume":"11","author":"HC Santos","year":"2025","unstructured":"Santos\u00a0HC, Rodrigues\u00a0A, Machado\u00a0T, Gon\u00e7alves-Pinho\u00a0M, Young\u00a0AH, Juruena\u00a0MF. (Es)ketamine as a treatment for depressive episodes with psychotic features: systematic review. BJPsych Open. 2025;11(6)e240. https:\/\/doi.org\/10.1192\/bjo.2025.10830.","journal-title":"BJPsych Open"},{"issue":"4","key":"587_CR7","doi-asserted-by":"publisher","first-page":"20r13459","DOI":"10.4088\/JCP.20R13459","volume":"82","author":"JKE Veraart","year":"2021","unstructured":"Veraart\u00a0JKE, Smith-Apeldoorn\u00a0SY, Spijker\u00a0J, Kamphuis\u00a0J, Schoevers\u00a0RA. Ketamine Treatment for Depression in Patients With a History of Psychosis or Current Psychotic Symptoms: A Systematic Review. Journal of Clinical Psychiatry. 2021;82(4):20r13459. https:\/\/doi.org\/10.4088\/JCP.20R13459.","journal-title":"Journal of Clinical Psychiatry"},{"issue":"1","key":"587_CR8","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1007\/s00787-024-02458-y","volume":"34","author":"AM Bruton","year":"2025","unstructured":"Bruton\u00a0AM, Wesemann\u00a0DG, Machingo\u00a0TA, Majak\u00a0G, Johnstone\u00a0JM, Marshall\u00a0RD. Ketamine for mood disorders, anxiety, and suicidality in children and adolescents: a systematic review. Eur Child Adolesc Psychiatry. 2025;34(1):141\u201357. https:\/\/doi.org\/10.1007\/s00787-024-02458-y.","journal-title":"European Child and Adolescent Psychiatry"},{"key":"587_CR9","doi-asserted-by":"publisher","unstructured":"Kosik-Gonzalez C, Fu DJ, Nancy Chen L, Lane R, Bloch MH, DelBello M, et al. Effect of Esketamine on Depressive Symptoms in Adolescents With Major Depressive Disorder at Imminent Suicide Risk: A Randomized Psychoactive-Controlled Study. Journal of the American Academy of Child & Adolescent Psychiatry. 2026;65(1):42\u201355. https:\/\/doi.org\/10.1016\/j.jaac.2025.02.015","DOI":"10.1016\/j.jaac.2025.02.015"},{"key":"587_CR10","doi-asserted-by":"publisher","DOI":"10.1177\/20420986251347360","volume":"16","author":"G Gutierrez","year":"2025","unstructured":"Gutierrez\u00a0G, Vazquez\u00a0G, Ravindran\u00a0N, Lam\u00a0RW, Giacobbe\u00a0P, Ganapathy\u00a0K, Kowara\u00a0A, Do\u00a0A, Baskaran\u00a0A, Nestor\u00a0SM, Swainson\u00a0J. Abuse liability for esketamine in a\u00a0cohort of patients undergoing an acute treatment course to manage treatment-resistant depression: a\u00a0secondary analysis of an observational study in real-world clinical practicee. Ther Adv Drug Saf. 2025;16:20420986251347360. https:\/\/doi.org\/10.1177\/20420986251347360.","journal-title":"Ther Adv Drug Saf"},{"key":"587_CR11","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-12-150","volume":"12","author":"L Clemmensen","year":"2012","unstructured":"Clemmensen\u00a0L, Vernal\u00a0DL, Steinhausen\u00a0HC. A systematic review of the long-term outcome of early onset schizophrenia. BMC Psychiatry. 2012;12:150. https:\/\/doi.org\/10.1186\/1471-244X-12-150.","journal-title":"BMC Psychiatry"}],"container-title":["neuropsychiatrie"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40211-026-00587-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40211-026-00587-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40211-026-00587-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:08:10Z","timestamp":1787656090000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40211-026-00587-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":11,"alternative-id":["587"],"URL":"https:\/\/doi.org\/10.1007\/s40211-026-00587-1","relation":{},"ISSN":["0948-6259","2194-1327"],"issn-type":[{"value":"0948-6259","type":"print"},{"value":"2194-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"23 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"N.\u00a0Schmelzle, K.\u00a0Neubacher and C.\u00a0Scharinger declare that no funding was received to assist with the preparation of this manuscript. P.L.\u00a0Plener was a\u00a0consultant for Boehringer-Ingelheim. He received speaker honoraria from GSK, Janssen, Medice, infectophram, consilium and Oral\u00a0B. He receives royalties from Hogrefe Publishers.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical review and approval was not required for the case report in accordance with the local legislation and institutional requirements. Informed consent was obtained from the patient for the publication of this case report.","order":2,"name":"Ethics","label":"Ethical standards","group":{"name":"EthicsHeading","label":"Declarations"}}]}}