Intranasal Esketamine Shows Efficacy for Treating Autism-Related Depression

June 13, 2022

Case Report Indicates Drug Also Decreased Suicidal Ideation and Improved Social Cognition

A twenty-four-year-old woman with autism recently finished a successful eight-week trial of intranasal esketamine to treat her comorbid symptoms of depression. The woman, who lives in Italy, had previously been misdiagnosed as bipolar and had a history of depression and suicidal thoughts. After receiving an accurate diagnosis of autism, doctors put her on two different depression medications (Fluvoxamine and Sertraline). Neither drug provided meaningful improvement. Last year, the woman started an eight-week trial of intranasal esketamine to treat her depression. From week one to four, she was administered 84 mg of esketamine twice weekly; from week five to eight, she received 84 mg once a week. The research team behind this case report ran several evaluations on the subject. Evaluations were administered at weeks one, four, and eight. These tests included the Montgomery Asberg Depression Rating Scale (MADRS), Columbia-Suicide Severity Rating Scale (C-SSRS), Dissociative Experiences Scale (DES-II), Psychache Scale (PSA), and Reading the Mind in the Eyes Test (RMET). At the end of week eight, the MADRS scores decreased progressively, along with the PSA scores, showing a significant improvement in the subject’s depression symptoms. Most remarkably, her suicidal ideation, measured by the C-SSRS, disappeared without any relapse. The subject’s social cognition, measured by the RMET, showed improvement, although slight. No side effects were reported during the trial and her vitals were always stable. This case report suggests that intranasal esketamine could be efficacious and safe in treating drug-resistant depression comorbid to autism. The report’s authors believe their experience with intranasal esketamine could pave the way for future studies, including double-blind, randomized controlled trials. 

Original Study

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