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Efficacy of Esketamine in the Treatment of Depression With Psychotic Features: A Case Series

  • Elias Ajub
    Affiliations
    Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, Brazil
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  • Acioly L.T. Lacerda
    Correspondence
    Address correspondence to Acioly L.T. Lacerda, M.D., Ph.D., LiNC – Laboratório Interdisciplinar de Neurociências Clínicas, Psychiatry, Rua Dr. Pedro de Toledo, 669 – 3° andar, Vila Clementino, São Paulo-SP, 04039-032, Brazil.
    Affiliations
    Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, Brazil

    Laboratório Interdisciplinar de Neurociências Clínicas, Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
    Search for articles by this author
      Since the seminal work of Berman et al. (
      • Berman R.M.
      • Cappiello A.
      • Anand A.
      • Oren D.A.
      • Heninger G.R.
      • Charney D.S.
      • et al.
      Antidepressant effects of ketamine in depressed patients.
      ) demonstrating the rapid and robust antidepressant effects of ketamine, several clinical trials have confirmed ketamine as a highly effective treatment for treatment-resistant depression (TRD). In recent years, there has been a rapidly growing trend of off-label prescribing of ketamine to treat TRD patients in many clinics worldwide. Considering that the effects of ketamine administration have been used as a model for psychosis and that psychotic symptoms are frequently reported as side effects at anesthetic doses in humans (
      • Xu K.
      • Krystal J.H.
      • Ning Y.
      • Chen da C.
      • He H.
      • Wang D.
      • et al.
      Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia.
      ), ketamine has been contraindicated to treat psychotic depression in both clinical and research settings.
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