OBJECTIVE To evaluate the efficacy and safety of esketamine in the treatment of Treatment-Resistant Depression.METHODS The randomized controlled trials(RCTs)of esketamine in the treatment of treatment-resistant depression were collected from PubMed,CNKI,and other databases.The experimental group was treated with esketamine or esketamine combined with oral antidepressants,and the control group was treated with a placebo or placebo combined with oral antidepressants.Meta-analysis was performed using the statistical software RevMan 5.4.1.RESULTS According to the inclusion criteria,seven randomized controlled trials with 1 067 patients were finally included.The results of the meta-analysis showed that the experimental group was more effective in reducing the scores of the Montgomery-Asberg Depression Rating Scale(MADRS),with significant differences between the experimentaland control groups both within 7 days and 8 to 28 days after treatment(P＜0.05).Compared with the placebo group,esketamine significantly increased the rate of response and remission in treatment-resistant depression patients within 7 days and 8 to 28 days after treatment(P＜0.05).Patients in the esketamine group were more likely to experience adverse effects such as vertigo,paresthesia,dissociation,vomiting,dizziness,increased blood pressure,nausea,somnolence,and headache.CONCLUSION The results of this meta-analysis support the efficacy and safety of esketamine as an augmentation option for patients with treatment-resistant depression,and the esketamine group was more likely to have adverse reactions than the placebo group,and most of the adverse reactions were mild to moderate.
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