Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations

Allan Young

doi:10.2147/NDT.S388392

Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations

Allan Young

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Purpose: Treatment-resistant depression (TRD) is associated with profound morbidity for patients, placing a significant burden on those affected, the health service and wider society. Despite this, TRD remains chronically underserved in terms of viable treatment options. To address this gap, an advisory panel of psychiatrists and clinical researchers with experience in managing TRD convened to develop best practice statements on the use of esketamine nasal spray, one of the first TRD treatments to be licensed in 30 years. Methods: During a virtual meeting held on 12th November 2020, the advisory panel shared their experiences of using esketamine nasal spray in their clinical practice. The meeting focused on developing and refining recommendations for setting up and running an efficient esketamine nasal spray clinic for patients living with TRD. At the conclusion of the meeting, agreement was reached on all recommendation statements. Results: In setting up an esketamine nasal spray clinic, it is important to consider the logistical requirements involved and put measures in place to ensure it runs as efficiently as possible. Educating patients about the treatment and maintaining their well-being is paramount for preventing discontinuation. Putting in place checklists can be a useful strategy for ensuring treatment appointments run smoothly and safely. Conclusion: Providing additional treatment options for the management of TRD, such as esketamine nasal spray, is likely to be key to improving the long-term outcomes of this underserved patient population.

Original language	English
Pages (from-to)	433—441
Number of pages	9
Journal	Neuropsychiatric Disease and Treatment
Volume	19
DOIs	https://doi.org/10.2147/NDT.S388392
Publication status	Published - 24 Feb 2023

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10.2147/NDT.S388392

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@article{ae6e04fc246044299574999af56df3b0,

title = "Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations",

abstract = "Purpose: Treatment-resistant depression (TRD) is associated with profound morbidity for patients, placing a significant burden on those affected, the health service and wider society. Despite this, TRD remains chronically underserved in terms of viable treatment options. To address this gap, an advisory panel of psychiatrists and clinical researchers with experience in managing TRD convened to develop best practice statements on the use of esketamine nasal spray, one of the first TRD treatments to be licensed in 30 years. Methods: During a virtual meeting held on 12th November 2020, the advisory panel shared their experiences of using esketamine nasal spray in their clinical practice. The meeting focused on developing and refining recommendations for setting up and running an efficient esketamine nasal spray clinic for patients living with TRD. At the conclusion of the meeting, agreement was reached on all recommendation statements. Results: In setting up an esketamine nasal spray clinic, it is important to consider the logistical requirements involved and put measures in place to ensure it runs as efficiently as possible. Educating patients about the treatment and maintaining their well-being is paramount for preventing discontinuation. Putting in place checklists can be a useful strategy for ensuring treatment appointments run smoothly and safely. Conclusion: Providing additional treatment options for the management of TRD, such as esketamine nasal spray, is likely to be key to improving the long-term outcomes of this underserved patient population.",

author = "Allan Young",

note = "Funding Information: Janssen provided financial support to the advisory panel and was also in attendance. Janssen also provided financial support to Brandcast Health to help facilitate the meeting and for editorial assistance in the preparation of this report. Janssen contributed minimally in terms of prompting clarifications from the advisory panel for development of the report but did not directly contribute to the advisory process or the preparation of the manuscript. Professor Young{\textquoteright}s independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King{\textquoteright}s College London. Dr Juruena{\textquoteright}s independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King{\textquoteright}s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Funding Information: Mohamed Abdelghani: Vice president/President Elect of the Clinical TMS Society. Founder and Medical Director of Dyad Medical, London TMS Centre and London Esketamine Clinic. Honoraria and consultancy fees from Janssen and Takeda. Mario F Juruena: Honorary Consultant, South London and Maudsley NHS Foundation Trust (SLaM-NHS UK) supported by National Institute for Health Research (NIHR); Biomedical Research Centre (BRC) and Clinical Senior Lecturer at King{\textquoteright}s College London. Honoraria and consultancy fees from Janssen, Lundbeck, Libbs, EMS, and Daiichi Sankyo. Viktoriya L Nikolova: Honorarium and consultancy fee from Janssen. Ramin Nilforooshan: Professor in Psychiatry at University of Surrey and consultant psychiatrist at Surrey and Borders Partnership NHS Foundation Trust. Honorarium and consultancy fee from Janssen. Personal fees from Roche and Biogen. Allan H Young: Employed by King{\textquoteright}s College London; Honorary Consultant for SLaM (NHS UK); Deputy Editor of BJPsych Open; Consultant to Johnson & Johnson and Livanova. Paid lectures and advisory boards for AstraZeneca, Eli Lilly, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS Pathways, Sage, Novartis. Principal Investigator on: RESTORE-LIFE VNS registry study (funded by LivaNova, NCT03320304; An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression (funded by Janssen, NCT02497287); The Effects of Psilocybin on Cognitive Function in Healthy Participants (funded by COMPASS Pathways, EudraC No: 2018-000978-30); The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD) (funded by COMPASS Pathways, NCT03775200). UK Chief Investigator for Novartis MDD study MIJ821A12201. Grant funding (past and present): NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK). Janssen (UK). No shareholdings in pharmaceutical companies. The authors report no other potential conflicts of interest in this work. Publisher Copyright: {\textcopyright} 2023 Young et al.",

year = "2023",

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day = "24",

doi = "10.2147/NDT.S388392",

language = "English",

volume = "19",

pages = " 433—441",

journal = "Neuropsychiatric Disease and Treatment ",

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T1 - Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations

AU - Young, Allan

N1 - Funding Information: Janssen provided financial support to the advisory panel and was also in attendance. Janssen also provided financial support to Brandcast Health to help facilitate the meeting and for editorial assistance in the preparation of this report. Janssen contributed minimally in terms of prompting clarifications from the advisory panel for development of the report but did not directly contribute to the advisory process or the preparation of the manuscript. Professor Young’s independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. Dr Juruena’s independent research is funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. Funding Information: Mohamed Abdelghani: Vice president/President Elect of the Clinical TMS Society. Founder and Medical Director of Dyad Medical, London TMS Centre and London Esketamine Clinic. Honoraria and consultancy fees from Janssen and Takeda. Mario F Juruena: Honorary Consultant, South London and Maudsley NHS Foundation Trust (SLaM-NHS UK) supported by National Institute for Health Research (NIHR); Biomedical Research Centre (BRC) and Clinical Senior Lecturer at King’s College London. Honoraria and consultancy fees from Janssen, Lundbeck, Libbs, EMS, and Daiichi Sankyo. Viktoriya L Nikolova: Honorarium and consultancy fee from Janssen. Ramin Nilforooshan: Professor in Psychiatry at University of Surrey and consultant psychiatrist at Surrey and Borders Partnership NHS Foundation Trust. Honorarium and consultancy fee from Janssen. Personal fees from Roche and Biogen. Allan H Young: Employed by King’s College London; Honorary Consultant for SLaM (NHS UK); Deputy Editor of BJPsych Open; Consultant to Johnson & Johnson and Livanova. Paid lectures and advisory boards for AstraZeneca, Eli Lilly, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS Pathways, Sage, Novartis. Principal Investigator on: RESTORE-LIFE VNS registry study (funded by LivaNova, NCT03320304; An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression (funded by Janssen, NCT02497287); The Effects of Psilocybin on Cognitive Function in Healthy Participants (funded by COMPASS Pathways, EudraC No: 2018-000978-30); The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD) (funded by COMPASS Pathways, NCT03775200). UK Chief Investigator for Novartis MDD study MIJ821A12201. Grant funding (past and present): NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK). Janssen (UK). No shareholdings in pharmaceutical companies. The authors report no other potential conflicts of interest in this work. Publisher Copyright: © 2023 Young et al.

PY - 2023/2/24

Y1 - 2023/2/24

N2 - Purpose: Treatment-resistant depression (TRD) is associated with profound morbidity for patients, placing a significant burden on those affected, the health service and wider society. Despite this, TRD remains chronically underserved in terms of viable treatment options. To address this gap, an advisory panel of psychiatrists and clinical researchers with experience in managing TRD convened to develop best practice statements on the use of esketamine nasal spray, one of the first TRD treatments to be licensed in 30 years. Methods: During a virtual meeting held on 12th November 2020, the advisory panel shared their experiences of using esketamine nasal spray in their clinical practice. The meeting focused on developing and refining recommendations for setting up and running an efficient esketamine nasal spray clinic for patients living with TRD. At the conclusion of the meeting, agreement was reached on all recommendation statements. Results: In setting up an esketamine nasal spray clinic, it is important to consider the logistical requirements involved and put measures in place to ensure it runs as efficiently as possible. Educating patients about the treatment and maintaining their well-being is paramount for preventing discontinuation. Putting in place checklists can be a useful strategy for ensuring treatment appointments run smoothly and safely. Conclusion: Providing additional treatment options for the management of TRD, such as esketamine nasal spray, is likely to be key to improving the long-term outcomes of this underserved patient population.

AB - Purpose: Treatment-resistant depression (TRD) is associated with profound morbidity for patients, placing a significant burden on those affected, the health service and wider society. Despite this, TRD remains chronically underserved in terms of viable treatment options. To address this gap, an advisory panel of psychiatrists and clinical researchers with experience in managing TRD convened to develop best practice statements on the use of esketamine nasal spray, one of the first TRD treatments to be licensed in 30 years. Methods: During a virtual meeting held on 12th November 2020, the advisory panel shared their experiences of using esketamine nasal spray in their clinical practice. The meeting focused on developing and refining recommendations for setting up and running an efficient esketamine nasal spray clinic for patients living with TRD. At the conclusion of the meeting, agreement was reached on all recommendation statements. Results: In setting up an esketamine nasal spray clinic, it is important to consider the logistical requirements involved and put measures in place to ensure it runs as efficiently as possible. Educating patients about the treatment and maintaining their well-being is paramount for preventing discontinuation. Putting in place checklists can be a useful strategy for ensuring treatment appointments run smoothly and safely. Conclusion: Providing additional treatment options for the management of TRD, such as esketamine nasal spray, is likely to be key to improving the long-term outcomes of this underserved patient population.

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U2 - 10.2147/NDT.S388392

DO - 10.2147/NDT.S388392

M3 - Article

SN - 1178-2021

VL - 19

SP - 433—441

JO - Neuropsychiatric Disease and Treatment

JF - Neuropsychiatric Disease and Treatment

ER -

Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations

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