{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T18:30:07Z","timestamp":1773685807325,"version":"3.50.1"},"reference-count":8,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T00:00:00Z","timestamp":1658707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>About one third of patients with major depressive disorder (MDD) have treatment resistant depression (TRD). The difficulty of treating TRD especially in those with suicidal ideation and psychotic features demands treatments that are fast-acting, safe, and effective. Limited access, lack of viable options, and incomplete characterization of rapid-acting antidepressants has prevented widespread incorporation into treatment of patients with TRD. However, ketamine and its variations have shown promise of being effective treatment options for patients with TRD with psychotic features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case description<\/jats:title><jats:p>This 28-year-old patient with TRD with psychotic features received 14 treatments of intranasal esketamine over a 3-month period. This patient initially presented with anhedonia, difficulty sleeping, suicidal thoughts, and auditory hallucinations. The Quick Inventory of Depressive Symptomology (QIDS) was used to assess depression before each session.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After her first two treatment sessions within a week, this patient experienced a reduction in depression from severe to moderate according to the QIDS. Over 14 sessions, she had no significant adverse effects, including no psychotic symptoms during esketamine treatment, and was stabilized to mild depression without suicidal ideations. One year after treatment, she continues to be stable. She has not had auditory hallucinations since the esketamine treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This case report provides an example of a patient with severe TRD with psychotic features that showed significant improvement after treatment with intranasal esketamine. Larger studies are indicated to further elucidate the effectiveness and safety of intranasal esketamine, so it can be more widely used for patients with TRD with psychotic features.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.937996","type":"journal-article","created":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T05:50:35Z","timestamp":1658728235000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Case report: Intranasal esketamine for severe major depressive disorder with psychotic features"],"prefix":"10.3389","volume":"13","author":[{"given":"Maximilian","family":"Carter","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kassandra","family":"Solsrud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Mischel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1016\/j.jad.2020.09.071","article-title":"Comparative efficacy of racemic ketamine and esketamine for depression: a systematic review and meta-analysis","volume":"278","author":"Bahji","year":"2021","journal-title":"J Affect Disord."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.3390\/life11111186","article-title":"Ketamine\u2014new possibilities in the treatment of depression: a narrative review","volume":"11","author":"Kowalczyk","year":"2021","journal-title":"Life."},{"key":"B3","doi-asserted-by":"publisher","first-page":"648691","DOI":"10.3389\/fpsyg.2021.648691","article-title":"Intranasal ketamine for depression in adults: a systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials","volume":"12","author":"An","year":"2021","journal-title":"Front Psychol."},{"key":"B4","doi-asserted-by":"publisher","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."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e17352","DOI":"10.7759\/cureus.17352","article-title":"Efficacy and safety of intranasal esketamine in treatment-resistant depression in adults: a systematic review","volume":"13","author":"Sapkota","year":"2021","journal-title":"Cureus."},{"key":"B6","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1037\/pha0000437","article-title":"Compounded intranasal racemic ketamine for major depressive disorder: a case report","volume":"29","author":"Ziegler","year":"2021","journal-title":"Exp Clin Psychopharmacol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"35305","DOI":"10.4088\/JCP.20r13459","article-title":"Ketamine treatment for depression in patients with a history of psychosis or current psychotic symptoms: a systematic review","volume":"82","author":"Veraart","year":"2021","journal-title":"J Clin Psychiatry."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.1016\/j.biopsych.2017.06.011","article-title":"Efficacy of esketamine in the treatment of depression with psychotic features: a case series","volume":"83","author":"Ajub","year":"2018","journal-title":"Biol Psychiatry."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.937996\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,25]],"date-time":"2022-07-25T05:50:37Z","timestamp":1658728237000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.937996\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,25]]},"references-count":8,"alternative-id":["10.3389\/fpsyt.2022.937996"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2022.937996","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,25]]},"article-number":"937996"}}