Safety Monitoring and Treatment Continuation With Esketamine in TRD

In this episode, ‘Safety Monitoring and Treatment Continuation With Esketamine in TRD,’ the expert psychiatrist explores the following questions:

What does day-to-day safety monitoring for esketamine look like in treatment-resistant depression, and what are common misconceptions about the protocol?

What data support continuing esketamine therapy in treatment-resistant depression, and what most often leads patients to stop?

The expert psychiatrist examined safety as a layered process that begins with a trusting therapeutic relationship, continues with screening for medical contraindications and coordination with other clinicians, and extends to set, setting, and on-site emergency equipment. He clarified that vital signs every 5 minutes are not mandated and that monitoring should fit both the patient and the medication’s profile. Citing the SUSTAIN trials, he noted that responders who discontinue relapse after about a month on average, and listed insurance changes, moves, a wish to pause, intolerability, and inadequate response as common reasons for stopping.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, ‘Building an Interventional TRD Practice: From Setup to the Patient Experience,’ features the panelists advancing their conversation on treatment-resistant depression and focusing on how they launched their practice and what treatment asks of patients.