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Depresión resistente al tratamiento y esketamina intranasal: consenso español sobre los aspectos teóricos
Fernando Mora1,2, Jose Antoni Ramos-Quiroga3,4,5,6, Enrique Baca-García7,8,9,10,11,12,13,14
1Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain.
Frontiers in psychiatry
|August 21, 2025
Resumen
Este consenso español define la depresión resistente al tratamiento (DRT) y propone un algoritmo de tratamiento. Se destaca la esketamina intranasal
Área de la Ciencia:
- La neurociencia
- La psiquiatría
- Farmacología
Sus antecedentes:
- La depresión resistente al tratamiento (DRT) tiene un impacto significativo en los pacientes y conlleva una carga socioeconómica sustancial.
- La falta de consenso sobre la definición de TRD complica el manejo efectivo de los pacientes.
- La esketamina intranasal ofrece un nuevo enfoque terapéutico al mejorar la neuroplasticidad y la sinaptogénesis.
Objetivo del estudio:
- Establecer un consenso sobre los aspectos teóricos y conceptuales de la EDT en España.
- Proponer una definición clara de TRD y de la respuesta clínica.
- Describir el papel de la esketamina intranasal en el panorama del tratamiento de TRD.
Principales métodos:
- Un comité científico compuesto por diez expertos españoles en TRD llevó a cabo una revisión de la literatura (2014-2024).
- Las declaraciones se desarrollaron a través de grupos de discusión y se perfeccionaron utilizando la técnica de grupo nominal.
- El consenso se finalizó a través de una reunión de redacción.
Principales resultados:
- Se estableció una definición propuesta para el TRD y la respuesta clínica.
- Se analizó el impacto de la inercia terapéutica, incluidas sus causas y consecuencias.
- Se desarrolló un algoritmo de tratamiento para la TRD, incorporando estrategias de evaluación de la esketamina intranasal y la respuesta.
Conclusiones:
- Esto marca el primer consenso español sobre los aspectos teóricos de la TRD y el papel de la esketamina intranasal.
- Se desarrolló una definición propuesta de TRD y un algoritmo de tratamiento integral.
- El consenso tiene como objetivo mejorar el manejo de TRD y reducir la inercia terapéutica.
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