Uso de esketamina en depresión resistente al tratamiento: una revisión exploratoria sistemática
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https://doi.org/10.20453/rnp.v88i3.6424Palabras clave:
esketamina, depresión resistente al tratamiento, revisión sistemáticaResumen
Alrededor de un tercio de los pacientes con trastorno depresivo mayor no responden a la terapia antidepresiva, generándose la condición denominada depresión resistente al tratamiento (DRT). El objetivo de la presente revisión es evaluar la evidencia disponible acerca de la efectividad y/o eficacia del fármaco esketamina como terapia en casos de DRT, con enfoque principal en las características sociodemográficas y metodológicas de los estudios disponibles. Se realizó una revisión sistemática exploratoria del tema, usando los términos clave «esketamine» y «treatment resistant depression». Se seleccionaron ensayos clínicos que incluyeron desenlaces de eficacia y efectividad. Se recogió información sociodemográfica, características de los ensayos clínicos y de las intervenciones, resultados y riesgo de sesgo individual. Se incluyeron trece ensayos clínicos. Se encontraron diez definiciones distintas para DRT y tres para remisión. La población incluida fue mayoritariamente blanca, entre 18 y 64 años y sin comorbilidades médico-psiquiátricas. Se determinó que la vía preferente de administración del medicamento fue intranasal. Tres estudios favorecieron la eficacia de la esketamina a corto plazo; y cuatro señalaron lo contrario. Los eventos adversos más frecuentes fueron mareos y disociación. Hay resultados controversiales sobre la eficacia de la esketamina en DRT, pero la mayoría de las investigaciones coinciden en el buen perfil de seguridad del fármaco. Se concluye que no hay consenso en definiciones de DRT ni de remisión; y, dada la escasa variedad de las muestras estudiadas, los resultados no son generalizables para la población real.
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Derechos de autor 2025 Claudia Esther Dueñas Rotta, Enrique Sabogal Cornejo, Leandro Huayanay Falconi, Horacio Benjamin Vargas Murga
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
