{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:28:52Z","timestamp":1784827732725,"version":"3.55.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T00:00:00Z","timestamp":1594166400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Psychopharmacol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction and objectives:<\/jats:title>\n                    <jats:p>The impact of multiple subcutaneous (s.c.) esketamine injections on the blood pressure (BP) and heart rate (HR) of patients with unipolar and bipolar treatment-resistant depression (TRD) is poorly understood. This study aimed to assess the cardiovascular safety of multiple s.c. doses of esketamine in patients with TRD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Seventy TRD patients received 394 weekly s.c. esketamine injections in conjunction with oral antidepressant therapy for up to six weeks. Weekly esketamine doses were 0.5, 0.75 or 1.0\u2009mg\/kg according to each patient\u2019s response to treatment. Participants were monitored before each treatment and every 15\u2009minutes thereafter for 120\u2009minutes. We assessed systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR measurements for the entire treatment course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>BP increased after the first s.c. esketamine injection, reaching maximum mean SBP\/DBP levels of 4.87\/5.54\u2009mmHg within 30\u201345\u2009minutes. At the end of monitoring, 120\u2009minutes post dose, vital signs returned to pretreatment levels. We did not detect significant differences in BP between doses of 0.5, 0.75, and 1\u2009mg\/kg esketamine. Mean HR did not differ significantly between doses or before and after s.c. esketamine injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The BP changes observed with repeated s.c. esketamine injections were mild and well tolerated for doses up to 1\u2009mg\/kg. The s.c. route is a simple and safe method of esketamine administration, even for patients with clinical comorbidities, including obesity, hypertension, diabetes, and dyslipidemia. However, 14\/70 patients experienced treatment-emergent transient hypertension (SBP &gt;180\u2009mmHg and\/or a DBP &gt;110\u2009mmHg). Therefore, we strongly recommend monitoring BP for 90\u2009minutes after esketamine dosing. Since s.c. esketamine is cheap, requires less frequent dosing (once a week), and is a simpler procedure compared to intravenous infusions, it might have an impact on public health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0269881120922955","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T05:13:20Z","timestamp":1594185200000},"page":"1155-1162","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Effects of subcutaneous esketamine on blood pressure and heart rate in treatment-resistant depression"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9259-7104","authenticated-orcid":false,"given":"Lorena Catarina","family":"Del Sant","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana 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Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Nakahira","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor Augusto Rodovalho","family":"Fava","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo","family":"Delfino","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"},{"name":"PRODAF\u2014Programa de Transtornos Afetivos, Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Surjan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"},{"name":"PRODAF\u2014Programa de Transtornos Afetivos, Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus Souza","family":"Steiglich","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"},{"name":"PRODAF\u2014Programa de Transtornos Afetivos, Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme","family":"Abdo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6556-6852","authenticated-orcid":false,"given":"Frederico Molina","family":"Cohrs","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aroldo","family":"Liberatori","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Alberto","family":"Del Porto","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"},{"name":"PRODAF\u2014Programa de Transtornos Afetivos, Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Acioly Luiz 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