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      Use of intranasal esketamine in a girl with treatment-resistant depression and autism spectrum disorders: a case report

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          Abstract

          Major depression is a common comorbidity in autism spectrum disorder (ASD), often difficult to identify and to treat. Autistic subjects are more at risk for suicidal thoughts and behaviors compared to typically developing peers. Unfortunately, ASD individuals are more frequently treatment-resistant and often show side-effects which reduce efficacy. Intranasal esketamine has been recently approved as an add-on medication for treatment-resistant depression (TRD), but it has never been used in ASD with comorbid major depression. Of note, a pilot study of intranasal ketamine has shown no effect on social withdrawal in ASD without depression. The present case report describes the first girl with ASD and comorbid TRD treated with intranasal esketamine.

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          Efficacy and Safety of Intranasal Esketamine Adjunctive to Oral Antidepressant Therapy in Treatment-Resistant Depression

          Ella Daly, Jaskaran Singh, Maggie Fedgchin … (2018)
          Approximately one-third of patients with major depressive disorder (MDD) do not respond to available antidepressants.
          Article 0 comments Cited 206 times – based on 0 reviews     Review now
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            Efficacy and Safety of Intranasal Esketamine for the Rapid Reduction of Symptoms of Depression and Suicidality in Patients at Imminent Risk for Suicide: Results of a Double-Blind, Randomized, Placebo-Controlled Study

            Carla Canuso, Jaskaran Singh, Maggie Fedgchin … (2018)
            The authors compared the efficacy of standard-of-care treatment plus intranasal esketamine or placebo for rapid reduction of symptoms of major depression, including suicidality, among individuals at imminent suicide risk.
            Article 0 comments Cited 139 times – based on 0 reviews     Review now
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              A 20‐year study of suicide death in a statewide autism population

              Anne Kirby, Amanda V Bakian, Yue Zhang … (2019)
              Scientific Summary Growing concern about suicide risk among individuals with autism spectrum disorder (ASD) necessitates population‐based research to determine rates in representative samples and to inform appropriate prevention efforts. This study used existing surveillance data in Utah to determine incidence of suicide among individuals with ASD over a 20‐year period, and to characterize those who died. Between 1998 and 2017, 49 individuals with ASD died by suicide. Suicide cumulative incidence rates did not significantly differ between 1998 and 2012 across the ASD and non‐ASD populations. Between 2013 and 2017, the cumulative incidence of suicide in the ASD population was 0.17%, which was significantly higher than in the non‐ASD population (0.11%; P < 0.05). During this period, this difference was driven by suicide among females with ASD; suicide risk in females with ASD was over three times higher than in females without ASD (relative risk (RR): 3.42; P < 0.01). Among the individuals with ASD who died by suicide, average age at death and manner of death did not differ significantly between males and females. Ages at death by suicide ranged from 14 to 70 years (M[SD] = 32.41[15.98]). Individuals with ASD were significantly less likely to use firearms as a method of suicide (adjusted odds ratio: 0.33; P < 0.001). Study results expand understanding of suicide risk in ASD and point to the need for additional population‐based research into suicide attempts and ideation, as well as exploration of additional risk factors. Findings also suggest a need for further study of female suicide risk in ASD. Autism Research 2019, 12: 658–666. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. Lay Summary This study examined suicide risk among individuals with autism spectrum disorder (ASD) in Utah over a 20‐year period. Risk of suicide death in individuals with ASD was found to have increased over time and to be greater than in individuals without ASD between 2013 and 2017. Females with ASD were over three times as likely to die from suicide as females without ASD. Young people with ASD were at over twice the risk of suicide than young people without ASD. Individuals with ASD were less likely than others to die from firearm‐related suicides.
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                Author and article information

                Journal
                Journal ID (nlm-ta): EXCLI J
                Journal ID (iso-abbrev): EXCLI J
                Journal ID (publisher-id): EXCLI J
                Title: EXCLI Journal
                Publisher: Leibniz Research Centre for Working Environment and Human Factors
                ISSN (Electronic): 1611-2156
                Publication date (Electronic): 28 February 2022
                Publication date Collection: 2022
                Volume: 21
                Pages: 540-543
                Affiliations
                [1 ]Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
                [2 ]ASST Pavia, Pavia, Italy
                Author notes
                *To whom correspondence should be addressed: Natascia Brondino, Department of Brain and Behavioral Sciences, University of Pavia, Via Bassi 21, 27100 Pavia, Italy; Tel: +39 0382987246, E-mail: natascia.brondino@ 123456unipv.it
                Article
                Publisher ID: 2022-4694 Publisher ID: Doc540
                DOI: 10.17179/excli2022-4694
                PMC ID: 9150017
                PubMed ID: 35651653
                SO-VID: 6c9e6713-5a45-4f15-828a-af5e8d0eaf32
                Copyright © Copyright © 2022 Olivola et al.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence ( http://creativecommons.org/licenses/by/4.0/) You are free to copy, distribute and transmit the work, provided the original author and source are credited.

                History
                Date received : 15 January 2022
                Date accepted : 14 February 2022
                Categories
                Subject: Case Report

                Keywords: autism spectrum disorders,depression,esketamine,treatment-resistant
                Data availability:
                Keywords: autism spectrum disorders, depression, esketamine, treatment-resistant

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