Repeated doses of subcutaneous esketamine in patients with treatment-resistant depression: Case series in a general hospital in Southern Brazil

The use of esketamine appears to be a promising alternative, with rapid improvement in depressive symptoms and suicidal ideation. This study aimed to describe the benefits of subcutaneous (SC) esketamine in patients with treatment-resistant depression. The patients in this study were between 22 and 60 years of age, were diagnosed with treatment-resistant depression, and received SC esketamine. This study highlights that repeated esketamine doses may be a promising treatment option for patients with treatment-resistant depression. Eight of the nine patients met th e criteria for response to depressive symptoms at the end of the treatment period, as evaluated using the HAMD-17 scale. In addition, a reduction in suicidal ideation was observed in patients with depression according to item 9 of the HAM-D17 and item 3 of the PHQ-9. Adverse reactions were mild and transient, with no persistent complications. Thus, SC esketamine may be a safe and beneficial alternative for the treatment of resistant depression and suicidal ideation and/or behavior. The use of the SC route is shown to be possible, mainly because of its ease of use and cost reduction in both equipment and human resources.