đ˘ New data from a real-world study of 50,000+ patients with treatment-resistant depression (TRD) published in JAMA Psychiatry:
đ Study Question:
Does combining esketamine with an SSRI or SNRI affect long-term outcomes in TRD?
đ Key Findings (5-Year Follow-Up):
- â
 Esketamine + SNRI:
ââď¸ Lower all-cause mortality
ââď¸ Fewer hospitalizations
ââď¸ Reduced depressive relapse - â
 Esketamine + SSRI:
ââď¸ Lower incidence of suicide attempts - đ Overall: Low rates of adverse outcomes in all groups
đĄÂ Clinical Implications:
- Not all combinations are equalâpairing matters.
- Esketamine + SNRI may be preferred for reducing relapse/mortality
- Esketamine + SSRI may be considered in patients at risk for suicide
- Personalized treatment decisions can enhance outcomes in TRD
đ More than symptom reliefâitâs about survival, stability, and safety.

