Augmentation in depression: Esketamine, a new standard?

While new add-on treatments have been developed for augmentation in depression with benefits demonstrated compared to placebo, none have demonstrated superiority compared to previously available interventions until now. In a phase IIIb, randomized, active-controlled trial (ESCAPE-TRD), Reif et al. 1 Reif A. Bitter I. Buyze J. Cebulla K. Frey R. Fu D.-J. Ito T. Kambarov Y. Llorca P.-M. Oliveira-Maia A.J. et al. Esketamine Nasal Spray versus Quetiapine for Treatment-Resistant Depression. N. Engl. J. Med. 2023; 389: 1298-1309 Crossref Scopus (4) Google Scholar demonstrate the superiority of esketamine compared to quetiapine augmentation (the current standard-of-care).