Presentation (CTI)

OBJECTIVES: This study aimed to compare treatment response rates to intranasal esketamine as measured by the PHQ-9 and DSM-5-XC in a real-world outpatient setting, and to evaluate whether the DSM-5-XC identifies clinically meaningful symptom improvement not captured by the PHQ-9.
METHODS: A retrospective chart review was conducted on n=10 patients (age range: 19-48 years; 50% female, 50% male) receiving intranasal esketamine at Radial, an outpatient center. Patients carried a primary diagnosis of Major Depressive Disorder (MDD) (100%), with frequent comorbidities including Generalized Anxiety Disorder (GAD) (60%), Attention-Deficit/Hyperactivity Disorder (ADHD) (50%), suicidality (40%), and panic disorder (10%). Treatment response was defined as ≥50% reduction in PHQ-9 scores or ≥25% reduction in DSM-5-XC scores. Dosage was flexible per FDA guidelines, ranging from 56 to 84 mg per session.
RESULTS: A response to PHQ-9 was observed in 40% of patients. 50% met response criteria based on DSM-5-XC. In three cases, DSM-5-XC captured clinically meaningful improvement not reflected by PHQ-9, suggesting added value in its multidomain monitoring.
CONCLUSIONS: These findings support integrating the DSM-XC alongside the PHQ-9 to evaluate Spravato treatment outcomes. Comorbid conditions were common which underscored the importance of multidimensional assessment in care. Future research with larger samples and longer follow-up is required to validate these findings and refine measurement-based care models for esketamine treatment.