Read more about Spravato for Treatment Resistant Depression

Hello all! I wanted to share with you some new and exciting published research on intranasal esketamine as a treatment for depression. People often wonder what a treatment for depression can do for them. Will it just mask or dull their symptoms or actually impact their life in a meaningful way?

I found these two studies to answer this question quite well with regards to esketamine treatment and they elaborate how beyond symptom control, this treatment enhances quality of life and functioning in specific areas such as workplace productivity, presenteeism at work, and decreased impairment and disability in the workplace!

1. Esketamine and Quality of Life Improvement in Treatment-Resistant Depression (TRD)

Source: Journal of Clinical Psychopharmacology (Lupi et al.). Published in November 2025.

This study focuses on "real-world" clinical outcomes rather than only controlled trial data. The key findings include:

Comprehensive Improvement: Beyond just reducing depressive symptoms (as measured by traditional depression symptom scales), the study found that esketamine nasal spray significantly improved the overall Quality of Life (QoL) for patients.

Significant treatment Gains: Patients in the study started at Severe depression scores and ended their treatment at the end of the study within the mild symptom range!

Comparison to Standard Care: In comparison to other common TRD treatments, esketamine showed a more rapid and sustained advantage in improving functional health and well-being over a period of 32 weeks.

Early Response: Improvements in self-reported patient status (PGI-S) were often noted as early as the first week of treatment.

2. Esketamine on functional outcomes in major depressive disorder

Source: Journal of Psychiatric Research (Ji et al.), Published in January 2026

This article explores the functional outcomes of esketamine treatment.

Size and Quality of the study: The research aggregated data from 9 different studies with 138-676 participants in each study. The risk of bias in the studies was measured as low.

Measures they tracked: Apart from just measuring depression symptoms, they closely looked at validated psychometric instruments used to evaluate impairment in work, social, and home and family responsibilities. This makes this study very important to determine how much the burden of depression was improved as depression is one of the leading causes of disability worldwide.

Results from treatment:

• Remission rates (i.e. getting to a point of no symptoms) were twice as high (~40%) as placebo in this group that had already usually failed to respond to multiple medications.

• 65% of the treated participants had clinically significant improvements in functioning by Day 28.

• Work productivity was more significantly improved in the esketamine treated group than those who tried an add-on medication by week 8 and the gains continued to improve into week 32.

• Productivity loss, presenteeism and activity impairment were domains that were significantly improved with esketamine.

Why was this so effective?

• The authors believed that the unique benefit of esketamine for treating the most difficult symptoms of depression including anhedonia (the loss of pleasure or motivation) and cognitive symptoms (such as difficulty remembering things and focusing) were what caused such a significant improvement in functionality and productivity in all areas of life.

Key Takeaway for Both:

Both articles shift the focus from simple "symptom reduction" to functional recovery. They suggest that esketamine is particularly effective at helping patients with depression regain their ability to socialize and function in daily life, with better ability to complete their responsibilities and avoid lost time to disability, which is often the hardest part of depression to treat with standard antidepressants.

Please call or email us today to get more information on this state of the art treatment for depression.

Piedmont Interventional Psychiatry is one of only a few clinics in the metro San Jose area to offer this treatment.

Wishing you well,

Dr. Jaggi

Check out the Spravato Find a Treatment Center Tool at Spravato.com