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SUMMARY
- SPRAVATO has not been studied in patients with autism spectrum disorder (ASD).
- In the SPRAVATO clinical development program for treatment-resistant depression (TRD) and major depressive disorder with active suicidal ideation and intent (MDSI), patients with a current or prior diagnosis of autism spectrum disorder were excluded from the trials.1-5
- SPRAVATO is not contraindicated in patients with ASD and comorbid TRD or MDSI.
- Olivola et al (2022)6 presented a case report of a 24-year-old patient with ASD and comorbid TRD who was treated with SPRAVATO.
CASE REPORT
Olivola et al (2022)6 presented a case report of a 24-year-old patient with ASD and comorbid TRD without intellectual disability who was treated with SPRAVATO. She was previously nonresponsive to fluvoxamine 200 mg daily and had only a slight improvement in her depressive symptoms with sertraline 200 mg daily. The patient started on SPRAVATO nasal spray 84 mg twice weekly for 4 weeks decreasing to once weekly from week 5 through week 8. At the time of this publication, the patient had been continuing maintenance treatment of SPRAVATO at a twice-monthly frequency. No side effects were reported and her vital measurements remained stable during administration. The patient reported an improvement in her depressive symptoms, which was supported by a decrease in the Montgomery Åsberg Depression Rating Scale (MADRS) total score from a baseline score (>40 to a score >20 at week 12). Scores also continued to improve on the Columbia-Suicide Severity Rating Scale (C-SSRS), and Psychache Scale (PSA) scores over the 12-week period. Social cognition, assessed by the Reading the Mind in the Eyes Test (RMET), showed a slight increase, possibly due to a learning effect.
Literature Search
A literature search of MEDLINE®, EMBASE®, BIOSIS Previews®, and DERWENT® (and/or other resources, including internal/external databases) pertaining to this topic was conducted on 05 January 2025.
| 1 | Popova V, Daly EJ, Trivedi M. Supplement to: Efficacy and safety of flexibly dosed esketamine nasal spray combined with a newly initiated oral antidepressant in treatment-resistant depression: a randomized double-blind active-controlled study. Am J Psychiatry. 2019;176(6):428-438. |
| 2 | Fedgchin M, Trivedi M, Daly EJ, et al. Supplement to: Efficacy and safety of fixed-dose esketamine nasal spray combined with a new oral antidepressant in treatment-resistant depression: results of a randomized, double-blind, active-controlled study (TRANSFORM-1). Int J Neuropsychopharmacol. 2019;22(10):616-630. |
| 3 | Ochs-Ross R, Daly EJ, Zhang Y, et al. Supplement to: Efficacy and safety of esketamine nasal spray plus an oral antidepressant in elderly patients with treatment-resistant depression - TRANSFORM-3. Am J Geriatr Psychiatry. 2020;28(2):121-141. |
| 4 | Fu DJ, Ionescu DF, Li X, et al. Esketamine nasal spray for rapid reduction of major depressive disorder symptoms in patients who have active suicidal ideation with intent: double-blind, randomized study (ASPIRE I). J Clin Psychiatry. 2020;81(3):19m13191. |
| 5 | Ionescu DF, Fu DJ, Qiu X, et al. Esketamine nasal spray for rapid reduction of depressive symptoms in patients with major depressive disorder who have active suicide ideation with intent: results of a phase 3, double-blind, randomized study (ASPIRE II). Int J Neuropsychopharmacol. 2021;24(1):22-31. |
| 6 | Olivola M, Arienti V, Bassetti N, et al. Use of intranasal esketamine in a girl with treatment-resistant depression and autism spectrum disorders: a case report. EXCLI J. 2022;21:540-543. |
