Intranasal esketamine in the management of treatment-resistant depression in a patient with a history of emotional neglect in childhood
DOI:
https://doi.org/10.25118/2763-9037.2024.v14.1201Keywords:
Esketamine, Depressive Disorder, Treatment-Resistant, Child Abuse, Suicide, Attempted, ketamine, TRDAbstract
Introduction: Emotional neglect in childhood is a recognized risk factor for the development of Treatment-Resistant Depression (TRD) in adulthood. This case presents the association between emotional neglect in childhood, failure of conventional antidepressants, and partial success with intranasal esketamine associated with antidepressant in the treatment of TRD. Method: Case report. CAAE 82360424.6.0000.0082, Faculdade de Medicina do ABC, FMABC. Case Presentation: A 29-year-old woman, with a history of emotional neglect in childhood, started with a depressive episode at 15 years old. After treatment failures with conventional antidepressants, she was diagnosed with TRD and underwent therapy with intranasal esketamine associated with desvenlafaxine, resulting in partial improvement of depressive symptoms. Discussion: The clinical history highlights the association between emotional neglect in childhood and the development of TRD in adulthood. The lack of response to conventional antidepressants underscores the challenges faced in the treatment of TRD. Intranasal esketamine associated with desvenlafaxine has proven to be a promising therapeutic approach for cases of TRD, offering a treatment perspective. Conclusions: It emphasizes the importance of recognizing and addressing emotional neglect in childhood as a risk factor for TRD and the need to explore alternative therapeutic options, such as intranasal esketamine associated with antidepressants, for patients who do not respond to conventional antidepressants.
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