Limitations
psychotic symptoms, TRD, hallucinations, delusions
ADVERSE EVENT
As noted, these data are limited to those collected during the first (to our knowledge) open-label treatment session for patients being treated for TRD using esketamine nasal spray; consequently, doses were limited to 28 mg in patients ≥65 years and 56 mg for all others (In summary, although adverse event reports and CADSS scores generally move in the same direction, there is substantial variability in the dissociation-related experiences of patients taking esketamine, and there appears to be similar variability in the correlation between CADSS total scores and the identification of dissociation as an adverse event by observing clinicians. Even with this variability, however, it is clear that overt psychotic symptoms (delusions or hallucinations) are not a common aspect of the dissociative experiences associated with esketamine nasal spray administered in the dose range and frequency for which this agent is approved for use in TRD.