{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:11:07Z","timestamp":1788959467766,"version":"build-2803163510"},"reference-count":0,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"unspecified","delay-in-days":173,"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 Real-world data for intranasal esketamine in treatment-resistant depression (TRD) are needed to characterize effectiveness, suicidality, and tolerability in routine care. We evaluated induction phase outcomes in outpatients with TRD treated at the University Hospital Vienna.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective single-center registry study included adults with TRD initiating supervised intranasal esketamine. The primary endpoint was the change in clinician-rated depressive symptom severity (MADRS) from the pre-treatment (PV) to the end of induction (EOI) visit. MADRS scores across baseline (BL), PV, and EOI were analyzed using a mixed model for repeated measures. Secondary outcomes included MADRS three-factor change, self-rated depression score trajectories (PHQ-9), response\/remission rates, suicidal ideation, and tolerability.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 229 screened patients, 176 initiated esketamine and 156 completed induction. MADRS at BL was 31.5 (SD 6.4), PHQ-9 was 18.5 (SD 4.7). In the primary model, adjusted mean MADRS was 30.3 at PV and 17.7 at EOI, yielding a change of \u221212.5 points (95%CI \u221214.1 to \u221211.0;\n p<\/jats:italic>\n \u00a0<\u00a00.001; Hedges\u2019\n g<\/jats:italic>\n \u00a0=\u00a01.8). All MADRS factors improved, with the largest reduction in the affective\u2013anhedonic domain. PHQ-9 decreased steadily across treatments. Remission was 27.2% and response 57.4% at EOI. Suicidal ideation decreased significantly; no suicide or serious self-harm occurred during induction. Adverse events (AEs) were recorded in 34.7%, with AE-related discontinuation in 3.4%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Esketamine induction was associated with marked improvement in depressive symptoms and suicidality, with acceptable tolerability under supervised administration. Longer-term registry follow-up and controlled comparative studies are needed to further define the benefit\u2013risk profile beyond induction phase.<\/jats:p>\n <\/jats:sec>","DOI":"10.1192\/j.eurpsy.2026.12234","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:56:06Z","timestamp":1782212166000},"source":"Crossref","is-referenced-by-count":0,"title":["Real-world effectiveness and safety of intranasal esketamine for treatment-resistant depression: Data from the enTRD registry"],"prefix":"10.1192","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5044-9090","authenticated-orcid":false,"given":"Maximilian","family":"Preiss","sequence":"first","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1134-3554","authenticated-orcid":false,"given":"Valentin","family":"Popper","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5185-0701","authenticated-orcid":false,"given":"Luna Helene Charlotte","family":"Faber","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8186-3320","authenticated-orcid":false,"given":"Theresa","family":"Baumgartner","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5841-9661","authenticated-orcid":false,"given":"Philip Miguel","family":"Baberis-Martinez","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5148-8566","authenticated-orcid":false,"given":"Edda","family":"Winkler-Pjrek","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7344-8071","authenticated-orcid":false,"given":"Gregor","family":"Gryglewski","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-8025","authenticated-orcid":false,"given":"Lucie","family":"Bartova","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8278-191X","authenticated-orcid":false,"given":"Siegfried","family":"Kasper","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1432-313X","authenticated-orcid":false,"given":"Dan","family":"Rujescu-Balcu","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1329-6352","authenticated-orcid":false,"given":"Lukas","family":"Pezawas","sequence":"additional","affiliation":[{"name":"Medical University of Vienna"},{"name":"Medical University of Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,6,23]]},"container-title":["European Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0924933826122342","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:02:33Z","timestamp":1788958953000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0924933826122342\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S0924933826122342"],"URL":"https:\/\/doi.org\/10.1192\/j.eurpsy.2026.12234","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":"e85"}}