Original Research J Clin Psychiatry May 2020

Esketamine Nasal Spray for Rapid Reduction of Major Depressive Disorder Symptoms in Patients Who Have Active Suicidal Ideation With Intent: Double-Blind, Randomized Study (ASPIRE I)

JCP 2020;81(3):10.4088/JCP.19m13191

Full Article Read the complete peer-reviewed article in J Clin Psychiatry. Clinical Summary Patients with major depressive disorder and active suicidal ideation with intent need symptom relief within hours, not weeks, yet standard antidepressants typically require 4-6 weeks to exert their full effect. This study tests whether esketamine nasal spray can rapidly reduce depressive symptoms in a psychiatric emergency population already receiving hospitalization and intensive standard-of-care treatment. FAQ How quickly did esketamine nasal spray improve depressive symptoms in adults with major depressive disorder and active suicidal ideation with intent?

Key Takeaways The antidepressant signal emerged within 4 hours after the first dose and remained generally present through day 25, suggesting esketamine can provide symptom relief during the interval before a newly initiated or optimized oral antidepressant is expected to take effect. Clinical Guide How do clinicians identify adults with major depressive disorder and active suicidal ideation with intent who fit the studied esketamine treatment setting? Clinical Guide How should clinicians implement the ASPIRE I esketamine nasal spray treatment and monitoring approach for hospitalized adults with major depressive disorder and active suicidal ideation with intent?