Ouyang Yannan, Li Juan
School of Education, The University of Queensland, Queensland, Australia.
Academic Affairs Office, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Medicine (Baltimore). 2025 Feb 28;104(9):e41495. doi: 10.1097/MD.0000000000041495.
The efficacy of esketamine nasal spray for treatment-resistant depression remains controversial. This systematic review and meta-analysis was conducted to explore the influence of esketamine nasal spray on treatment efficacy for treatment-resistant depression.
We conducted a comprehensive search across multiple databases, including PubMed, EMbase, Web of Science, EBSCO, and Cochrane library through March 2024 for randomized controlled trials (RCTs) assessing the effect of esketamine nasal spray on the treatment efficacy of depression. This meta-analysis was performed using the random-effect model.
Five RCTs are included in the meta-analysis. Overall, compared with control group treatment-resistant depression, esketamine nasal spray is associated with significantly reduced MADRS scores (SMD = -3.88; 95% confidence interval [CI] = -5.71 to -2.05; P < .0001), increased response rates (RR = 1.99; 95% CI = 1.28-3.10; P = .002), decreased Sheehan Disability Scale (SMD = -3.01; 95% CI = -4.39 to -1.64; P < .0001) and PHQ-9 scores (SMD = -2.32; 95% CI = -3.51 to -1.13; P = .0001), but leads to the increase in dizziness (RR = 3.55; 95% CI = 2.37-5.32; P < .00001) and nausea (RR = 3.88; 95% CI = 2.10-7.18; P < .0001).
Esketamine nasal spray is beneficial to improve the efficacy of treatment-resistant depression.
艾氯胺酮鼻喷雾剂治疗难治性抑郁症的疗效仍存在争议。本系统评价和荟萃分析旨在探讨艾氯胺酮鼻喷雾剂对难治性抑郁症治疗效果的影响。
我们对多个数据库进行了全面检索，包括截至2024年3月的PubMed、EMbase、Web of Science、EBSCO和Cochrane图书馆，以查找评估艾氯胺酮鼻喷雾剂对抑郁症治疗效果的随机对照试验（RCT）。本荟萃分析采用随机效应模型进行。
荟萃分析纳入了5项RCT。总体而言，与对照组治疗难治性抑郁症相比，艾氯胺酮鼻喷雾剂与蒙哥马利-艾森伯格抑郁评定量表（MADRS）评分显著降低相关（标准化均数差[SMD]=-3.88；95%置信区间[CI]=-5.71至-2.05；P<.0001），缓解率增加（RR=1.99；95%CI=1.28-3.10；P=.002），希恩残疾量表（SMD=-3.01；95%CI=-4.39至-1.64；P<.0001）和患者健康问卷-9（PHQ-9）评分降低（SMD=-2.32；95%CI=-3.51至-1.13；P=.0001），但会导致头晕（RR=3.55；95%CI=2.37-5.32；P<.00001）和恶心（RR=3.88；95%CI=2.10-7.18；P<.0001）增加。
艾氯胺酮鼻喷雾剂有利于提高难治性抑郁症的治疗效果。
