{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:08:43Z","timestamp":1787170123061,"version":"build-2736575974"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"17","license":[{"start":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T00:00:00Z","timestamp":1596067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To review the efficacy, safety, and place in therapy of intranasal esketamine, a treatment modality for treatment-resistant depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>An electronic literature search of PubMed, MEDLINE, and the ClinicalTrials.gov and Food and Drug Administration (FDA) websites covering the period April 2015 through June 2020 was performed using the following search terms: esketamine, intranasal esketamine, depression, and treatment-resistant depression. Other resources included review articles and the manufacturer\u2019s product labeling. All relevant English-language articles and reports on clinical trials conducted in humans were included. Esketamine (Spravato, Janssen Pharmaceuticals) is an intranasal antidepressant approved by FDA for management of treatment-resistant depression (TRD) in patients with inadequate response to traditional antidepressant therapy. Esketamine is self-administered under the supervision of a healthcare provider and is used as an adjunct to oral antidepressant therapy. Patients are supervised for 2 hours after self-administering the medication to monitor for sedation, dizziness, dissociation reactions, and increased blood pressure. Esketamine has a favorable risk-to-benefit profile, with demonstrated efficacy in reducing depressive symptoms more rapidly than monotherapy with traditional oral antidepressants. Reported adverse effects include sedation, dizziness, dissociation reactions, and blood pressure elevations, but these effects are primarily confined to the 2-hour postdose monitoring window.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with moderate to severe depression who are not sufficiently responsive to traditional strategies for managing TRD may benefit from adjunctive esketamine therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxaa191","type":"journal-article","created":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T08:57:18Z","timestamp":1596099438000},"page":"1382-1388","source":"Crossref","is-referenced-by-count":17,"title":["Intranasal esketamine: A novel drug for treatment-resistant depression"],"prefix":"10.1093","volume":"77","author":[{"given":"Farah","family":"Khorassani","sequence":"first","affiliation":[{"name":"Department of Clinical Health Professions, St. John\u2019s University College of Pharmacy and Health Sciences, Queens, NY"},{"name":"Department of Pharmacy, Bellevue Hospital Center, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Om","family":"Talreja","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Allegheny General Hospital, Pittsburgh, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,30]]},"reference":[{"key":"2020082004572189000_CIT0001","author":"National Institute of Mental Health Major depression"},{"key":"2020082004572189000_CIT0002","doi-asserted-by":"crossref","first-page":"16065","DOI":"10.1038\/nrdp.2016.65","article-title":"Major depressive disorder","volume":"2","author":"Otte","year":"2016","journal-title":"Nat Rev 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placebo-controlled study","volume":"175","author":"Canuso","year":"2018","journal-title":"Am J Psychiatry"},{"key":"2020082004572189000_CIT0009","author":"Janssen Pharmaceuticals"},{"issue":"6","key":"2020082004572189000_CIT0010","first-page":"340","article-title":"Intranasal esketamine (SpravatoTM) for use in treatment-resistant depression in conjunction with an oral antidepressant","volume":"44","author":"Bahr","year":"2019","journal-title":"Pharm Ther"},{"issue":"2","key":"2020082004572189000_CIT0011","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1001\/jamapsychiatry.2017.3739","article-title":"Efficacy and safety of intranasal esketamine adjunctive to oral antidepressant therapy in treatment-resistant depression","volume":"75","author":"Daly","year":"2018","journal-title":"JAMA Psychiatry"},{"key":"2020082004572189000_CIT0012","doi-asserted-by":"crossref","DOI":"10.1093\/ijnp\/pyz039","article-title":"Efficacy and safety of fixed-dose esketamine nasal spray combined with a new oral antidepressant in treatment-resistant depression: results of a randomized, double-blind, active-controlled study (TRANSFORM-1)","author":"Fedgchin","year":"2019","journal-title":"Int J Neuropsychopharmacol"},{"issue":"6","key":"2020082004572189000_CIT0013","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1176\/appi.ajp.2019.19020172","article-title":"Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression: a randomized double-blind active-controlled study","volume":"176","author":"Popova","year":"2019","journal-title":"Am J Psychiatry"},{"issue":"9","key":"2020082004572189000_CIT0014","doi-asserted-by":"crossref","first-page":"S391","DOI":"10.1016\/j.biopsych.2018.02.1005","article-title":"S114. Efficacy and safety of intranasal esketamine plus an oral antidepressant in elderly patients with treatment-resistant depression","volume":"83","author":"Ochs-Ross","year":"2018","journal-title":"Biol Psychiatry"},{"issue":"9","key":"2020082004572189000_CIT0015","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1001\/jamapsychiatry.2019.1189","article-title":"Efficacy of esketamine nasal spray plus oral antidepressant treatment for relapse prevention in patients with treatment-resistant depression","volume":"76","author":"Daly","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"2020082004572189000_CIT0016","author":"ClinicalTrials.gov"},{"key":"2020082004572189000_CIT0017","author":"ClinicalTrials.gov"},{"key":"2020082004572189000_CIT0018","author":"Popova","year":"2018"},{"key":"2020082004572189000_CIT0019","author":"Ng"},{"key":"2020082004572189000_CIT0020","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.coph.2014.11.005","article-title":"How does ketamine elicit a rapid antidepressant response?","volume":"20","author":"Kavalali","year":"2015","journal-title":"Curr Opin Pharmacol"},{"key":"2020082004572189000_CIT0021","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1176\/appi.ajp.2018.18070834","article-title":"Single, Repeated, and Maintenance Ketamine Infusions for Treatment-Resistant Depression: A Randomized Controlled Trial","volume":"176","author":"Phillips","year":"2019","journal-title":"Am J Psychiatry"},{"key":"2020082004572189000_CIT0022","article-title":"Spravato.","volume-title":"Red Book Online [database on the Internet]","year":"2019"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ajhp\/article-pdf\/77\/17\/1382\/33665643\/zxaa191.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ajhp\/article-pdf\/77\/17\/1382\/33665643\/zxaa191.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T05:31:06Z","timestamp":1597901466000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/77\/17\/1382\/5878872"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,30]]},"references-count":22,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2020,7,30]]},"published-print":{"date-parts":[[2020,8,20]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxaa191","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,9,1]]},"published":{"date-parts":[[2020,7,30]]}}}