{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:47:30Z","timestamp":1785422850488,"version":"3.56.0"},"reference-count":0,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T00:00:00Z","timestamp":1781568000000},"content-version":"unspecified","delay-in-days":166,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur. Psychiatr."],"published-print":{"date-parts":[[2026]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Previous research has demonstrated the positive impact of early remission on disease trajectory for patients with major depressive disorder. However, there is a paucity of literature assessing the response trajectory for patients with treatment resistant depression (TRD). These analyses investigated patient outcome trajectories to Week 32, including the relationship between short- and long-term outcomes with esketamine nasal spray (ESK-NS) treatment and symptom resolution.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n ESCAPE-TRD (NCT04338321), a randomized, open-label, phase IIIb study, evaluated the efficacy and safety of ESK-NS versus quetiapine extended release (QTP-XR) in patients with TRD. Rater-blinded Montgomery-\u00c5sberg Depression Rating Scale (MADRS) total score was used to assess depressive symptoms and the trajectory of patient responses to Week 32. For ESK-NS versus QTP-XR, time to symptom resolution across MADRS items was evaluated using Kaplan\u2013Meier analyses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 676 patients, 336 and 340 were randomized to ESK-NS and QTP-XR, respectively. Most ESK-NS-treated patients achieved continuously improved outcomes to Week 32; early response was associated with better long-term outcomes. Among patients who achieved Week 4 response, 89.6% achieved remission at any point from Week 4 to 32; 78.3% of Week 8 responders achieved remission at any point from Week 8 to 32. Greater and earlier symptom resolution was observed with ESK-NS versus QTP-XR across most MADRS items.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Most ESK-NS-treated patients with TRD showed continuous improvements over time, with short-term response associated with better long-term outcomes. Long-term improvements were observed even among partial\/minimal early responders, reinforcing the value of longer treatment. ESK-NS had a positive impact across the full spectrum of MADRS-assessed symptoms.<\/jats:p>\n <\/jats:sec>","DOI":"10.1192\/j.eurpsy.2026.12229","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:21:51Z","timestamp":1781698911000},"source":"Crossref","is-referenced-by-count":0,"title":["Trajectory of response to esketamine nasal spray for treatment resistant depression: Findings from ESCAPE-TRD"],"prefix":"10.1192","volume":"69","author":[{"given":"Allan H.","family":"Young","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0220mzb33","id-type":"ROR","asserted-by":"publisher"}],"name":"Institute of Psychiatry"},{"name":"South London and Maudsley NHS Foundation Trust"},{"name":"Imperial College London"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-8025","authenticated-orcid":false,"given":"Lucie","family":"Bartova","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05n3x4p02","id-type":"ROR","asserted-by":"publisher"}],"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9633-0888","authenticated-orcid":false,"given":"Narc\u00eds","family":"Cardoner","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/059n1d175","id-type":"ROR","asserted-by":"publisher"}],"name":"Institut d\u2019Investigaci\u00f3 Biom\u00e8dica Sant Pau"},{"name":"Carlos III Health Institute"},{"name":"Universitat Aut\u00f2noma de Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5331-487X","authenticated-orcid":false,"given":"Koen","family":"Demyttenaere","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05f950310","id-type":"ROR","asserted-by":"publisher"}],"name":"University Psychiatric Centre KU"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Fagiolini","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01tevnk56","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Siena School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yordan","family":"Godinov","sequence":"additional","affiliation":[{"name":"Johnson & Johnson"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9089-8227","authenticated-orcid":false,"given":"Jos\u00e9 Felipe","family":"Golib Dzib","sequence":"additional","affiliation":[{"name":"Johnson & Johnson"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"von Holt","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/023edjq13","id-type":"ROR","asserted-by":"publisher"}],"name":"Johnson & Johnson"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4733-2523","authenticated-orcid":false,"given":"Roger S.","family":"McIntyre","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5071-3007","authenticated-orcid":false,"given":"Albino J.","family":"Oliveira-Maia","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03g001n57","id-type":"ROR","asserted-by":"publisher"}],"name":"Champalimaud Research and Clinical Centre"},{"name":"Universidade NOVA de Lisboa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Rive","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02g40zn06","id-type":"ROR","asserted-by":"publisher"}],"name":"Johnson & Johnson"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1845-3676","authenticated-orcid":false,"given":"Philip","family":"Gorwood","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9"},{"name":"GHU Paris Psychiatrie et Neurosciences (CMME)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,6,16]]},"container-title":["European Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0924933826122299","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:04:02Z","timestamp":1784621042000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0924933826122299\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S0924933826122299"],"URL":"https:\/\/doi.org\/10.1192\/j.eurpsy.2026.12229","relation":{},"ISSN":["0924-9338","1778-3585"],"issn-type":[{"value":"0924-9338","type":"print"},{"value":"1778-3585","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e74"}}