Posted on 04/20/2025 8:08:40 PM PDT by ConservativeMind
Major depressive disorder (MDD) affects approximately 280 million people globally and is one of the leading causes of disability. One in every three people suffering from MDD also has to deal with treatment-resistant depression (TRD), a condition where patients do not respond to at least two antidepressant trials.
Esketamine nasal spray, a rapid-acting anti-depressant, is known to be effective against TRD when administered alongside antidepressants like selective serotonin reuptake inhibitor (SSRI) or a serotonin-norepinephrine reuptake inhibitor (SNRI).
A study retrospectively compared the effectiveness of both the combinations in treating TRD and found that esketamine plus SNRI showed significantly better overall results than esketamine plus SSRI.
While the effectiveness of esketamine combined with either SSRI or SNRI in treating TRD has been widely explored, it has been unclear which pairing has the advantage in different clinical aspects.
To bridge this gap in understanding, this study analyzed a population-based sample of over 55,000 patients.
The patients were then split into two equal groups of those who received esketamine plus SSRI and esketamine plus SNRI.
SSRIs administered in the study comprised citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, and vilazodone. The SNRI group consisted of desvenlafaxine, duloxetine, levomilnacipran, milnacipran, and venlafaxine.
They observed an overall decline in primary outcomes; however, patients treated with esketamine and SNRI had significantly lower rates of all-cause mortality (5.3%), hospitalizations (0.1%), and depression relapses (14.8%) compared to those who received esketamine with an SSRI, where the risk rates were 9.1%, 0.2% and 21.2%, respectively.
Statistical analysis also revealed that over the five-year period, patients who got the SNRI combo showed a higher survival probability of 91.4% than those in the SSRI group with 86.9%.
Both the treatment plans reduced the number of suicide attempts, but the cases were lower in those who received an SSRI, 0.3% vs. 0.5%.
(Excerpt) Read more at medicalxpress.com ...
However did the human race survive the millions of years before Big Pharma rolled out its prescription pscychotropic brain poisons?
Not 100 percent of humans had depression. Just like today. My daughter suffers from it. She finally may have found something that works.
We live in a "drugs are the answer" culture, and then we are surprised when there are so many druggies.
Staying busy and exercise is my guess.
Better nutrition?
No, can’t take SNRI’s nor SSRI’s.
Not well.
People with emotional problems that drugs can help now used to be locked up in insane asylum forever,
Or people committed suicide or were not functional
None of that happens now that we have drugs to solve our problems.
Guess you have never taken a drug,,,
Oh, you mean people with emotional problems,,,well golly, guess you didn’t know depression is a clinical physiological problem, like diabetes.
Guess “ drugs are the answer “ is something you might want to say to a guy with ED.
Hope your daughter is helped by her treatment.
thanks for posting. Esketamine is a really dangerous hallucinogenic drug that has to be taken in a clinic, only as a last resort for depression.
It pains me to see knee-jerk reactions condemning use of medications for depression here on this forum and elsewhere. I think people simply don’t understand what clinical depression is and that the endgame for many is suicide. OK? I don’t care if Big Pharma is making trillions as long their drugs work. People who think a drug has to work all the time for everyone to be considered as a treatment simply don’t understand the nature of mental illness. There is no one-size fits all. The haters can hang their hats on instances of bad side effects or unproven links to suicide while ignoring the fact that anti-depressants have helped millions. If you want to cry bullshit, look at the billions spent every year on talk therapies. Patients can go for years yapping about how badly they were treated by parents or others and still feel no relief. When medication for depression works it can improve and even save lives.
Just about every mass shooter is on them, so there’s that.
Agreed but please let’s keep balance on both sides. Pharmaceutical drugs are a blessing but we have an opioid epidemic that’s destroyed an astronomical amount of lives. (For starters…) And even trillions of dollars can’t make up for that.
Psychiatric drugs have played a role in saving or bettering countless lives — but they can have catastrophic consequences on some brains if wrongly prescribed, combined, abused, started at too high a dose, etc… :(. Sometimes the side effects themselves worsen the very conditions they’re meant to treat.
It takes a lot of care, skill, precision, AND supervision on the part of psychiatrists to *individualize* their treatment plan and adjust with their patient as their issues evolve — hopefully resolve.* Kudos when just one med is needed, and just for a season at that — but some may need it permanently.
Religion had even less a reference point pre-modern medicine so a lot of clinical health conditions — mental or otherwise — were viewed solely as supernatural attacks.
There likely is a very real spiritual dimension to the whole scope of the human mind AND body, so it’s refreshing when a psychiatrist or pharmacologist has both medical understanding AND faith.
“However did the human race survive the millions of years before Big Pharma rolled out its prescription pscychotropic brain poisons?”
Many did not. Many died of suicide or alcoholism. Unless you have experienced depression you know not what you speak.
Ketamine is like the ivermectin of antidepressants. One should carefully assess any study’s methods and provenance before making definitive statements. I make no judgements either way, but a lot of money is at stake here.
My only son took his own life in June 2023 while in the throes of a mental health crisis. He was on sertraline but had terrible side effects. He was then prescribed Wellbutrin but was told it took 4-6 weeks to work. After 3-1/2 weeks, he couldn’t take it anymore and ended his life. We miss him every single day and our lives will never be the same.
The severely depressed died.
You are talking about severe depression as if it was a bad mood.
Severe depression is a brain disease... like diabetes is an endocrine disease.
About 120 years ago treatment became available for diabetes. Before that they died.
About 50 years ago treatment became available for severe depression. Before then they died.
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