Navigating Treatment-Resistant Major Depressive Disorder With Suicidal Ideation: Exploring the Efficacy of Spravato (Esketamine) in an 86-Year-Old Male

This case study examines the novel application of Spravato (intranasal esketamine) to address treatment-resistant Major Depressive Disorder (MDD) in an 86-year-old patient. Notably, this represents one of the oldest documented individuals to be administered intranasal esketamine for a diagnosis of Treatment-Resistant Depression (TRD) alongside suicidal ideation. This case study contributes to the growing body of evidence on its use in elderly populations suffering from MDD with suicidal ideation. Given the limited research on intranasal esketamine therapy in geriatric populations, this study highlights unique pharmacodynamic and clinical challenges specific to this demographic, particularly regarding advanced age, comorbidities, and sensitivity to adverse effects. Under the supervision of a double board-certified adult and geriatric psychiatrist, this case study examines how intranasal esketamine therapy can lead to positive treatment outcomes in geriatric populations. This case study also addresses the safety and efficacy of intranasal esketamine therapy, contributing to the broader discourse on its potential as a viable treatment option for TRD, especially for geriatric patients resistant to traditional therapies. While current literature primarily focuses on individuals aged 65 and younger, this case study aims to provide insights into future applications in geriatric populations to improve existing clinical guidelines.