Behavioural Activation Therapy and Esketamine for Resistant Depression
Randomised, parallel-arm trial (n=6 actual) comparing concurrent behavioural activation therapy plus intranasal esketamine versus esketamine alone for treatment-resistant depressive episodes in MDD or BD.
Details
This single-site, parallel-arm randomized clinical trial tests whether combining behavioural activation therapy with intranasal esketamine produces larger, faster, and more sustained reductions in depressive symptoms than esketamine alone.
Esketamine is administered intranasally with an induction phase (twice weekly for 4 weeks) followed by maintenance (once weekly or biweekly) for a total treatment period of 12 weeks; BA therapy consists of 12 weekly one-hour sessions delivered virtually or in person.
Primary outcomes assess depressive symptom change and speed of antidepressant response; secondary outcomes include functional recovery measures and treatment feasibility in a naturalistic academic-hospital setting.