Interpretation of the Montgomery–Åsberg Depression Rating Scale (MADRS)
Susan Paketci
Abstract
Third, with regard to suicide, the results presented in their Table To tabulate these suicides against placebo is invalid. Suicidality is a main component of TRD. 2 The completed suicide rate in the esketamine development programme is 0.17 per 100 patient years, less than the completed suicide rate of 0.47 per 100 patient years in a recent meta-analysis of 15 000 patients with TRD. Safety studies 5 as well as practical experience 6 indicate that most treatment-emergent side-effects occurred on dosing days, were mild or moderate in severity, and resolved on the same day. Cognitive performance generally either improved or remained stable post baseline. Treatment-emergent dissociative symptoms were transient and generally resolved within 1.5 h post dose. There was no case of interstitial cystitis or respiratory depression. sketamine nasal spray is a treatment for TRD which has a novel mechanism of action and offers an additional therapeutic option for patients who have already failed several lines of treatment. Your instructions require authors of 'analysis' papers to provide 'an unbiased approach in evaluating the relevant evidence'. Patients, their therapists and the research teams who have worked on esketamine across the world deserve them to be observed better than this.