Prof. Marcin Wojnar: We have been waiting for a breakthrough in the treatment of depression for many years

Psychiatrists stress that when we talk about the introduction of a drug program in drug-resistant depression, using esketamine, we are talking about a breakthrough. Why is this so important from the point of view of clinicians, but also their patients?

First, it is worth emphasizing what this breakthrough will consist of, and this will justify why we have waited so long for it. Standard treatment with antidepressants usually has to last several weeks before the patient shows improvement. Another few before complete remission occurs. And given this dysfunction or functioning problems and the level of suffering that depression brings, the patient actually waits a very long time before feeling relief. On the other hand, it's the case that we're not sure if the drug will work either. So this waiting period is prolonged for everyone, and the patients, their families, and us doctors. Esquetamine, in this respect, brings such a change that it can work after the second application, that improvement in the patient can occur even hours after a single application, a single administration of the drug. Therefore, the time in which the patient suffers is definitely reduced. The second element worth emphasizing is that this drug works by a completely different mechanism than existing antidepressants. He uses a more effective way to reach the nervous system and relieve depression and is more effective in general as an antidepressant medication. It is used together with an antidepressant, but in a special situation - when the depression is drug-resistant, that is, when the depression does not respond to standard medications. This drug brings a new quality precisely because it breaks drug resistance, is able to give improvement despite the fact that no other drugs have brought it so far.

And drug resistance affects about a third of the group of patients with depression. We know that depression is diagnosed in about 1.5 million Poles, but at the same time we don't know how many people don't see a doctor.

It is true that drug-resistant depression is estimated to be between 25 and 35 percent of treated patients, because only in these patients are we able to confirm that their depressive episode is not responding to the medications used. A large proportion of patients who are not yet patients remain untreated. And there are estimates that it's 50 or even 60 percent of all cases of depression that go undiagnosed, go untreated and remain without help. It may therefore be that a breakthrough agent like escatemine can be applied to an even larger group of people who are waiting for treatment somewhere in our country.

It should also be said that we are talking about a fatal disease. Especially in the case of drug-resistant depression, where the number of suicide attempts is very high.

Epidemiological studies show that in drug-resistant depression, which is fraught with a number of much greater consequences than the average episode of depression, the one undergoing treatment, the risk of a suicide attempt is as much as seven times higher than that of treatable depression. This shows the danger that comes with depression. And it shows the importance of treating this group of non-responders to standard forms of therapy.