Managing Esketamine Treatment Frequency Toward Successful Outcomes: Analysis of Phase 3 Data.

BACKGROUND: Esketamine nasal spray was recently approved for treatment-resistant depression (TRD). The current analysis evaluated the impact of symptom-based treatment frequency changes during esketamine treatment on clinical outcomes. METHODS: This is a post-hoc analysis of an open-label, long-term (up to 1 year) study of esketamine in patients with TRD (SUSTAIN 2). During a 4-week Induction phase, 778 patients self-administered esketamine twice-weekly plus a new oral antidepressant daily. In responders (>/=50% reduction in Montgomery-Asberg Depression Rating Scale [MADRS] total score from baseline), esketamine treatment frequency was thereafter decreased during an Optimization/Maintenance phase, to weekly for 4 weeks and then adjusted to the lowest frequency (weekly or every-other-week) that maintained remission (MADRS