September 3, 2020

expert reaction to NICE launching a second public consultation on its draft guidance which does not recommend an Esketamine nasal spray medicine for treatment-resistant depression

The National Institute of Health and Care Excellence (NICE) have announced a second public consultation on its draft guidance which does not recommend an Esketamine nasal spray medicine for treatment-resistant depression.

Prof David Curtis, retired consultant psychiatrist and Honorary Professor at University College London and Queen Mary University of London, said:

“I’m pleased and not surprised that NICE has taken this position. Many experts felt that esketamine had been licensed without really strong evidence that it worked better than conventional antidepressants and could offer real benefits to patients. It is certainly the case that not all patients respond well to antidepressants and doctors would love to have more effective treatments but the initial trials of esketamine were far from convincing. Additionally, delivering esketamine to patients is inherently problematic, as they have to be monitored for a period after administration so one would need to set up special clinics just for this purpose. And let’s not forget that esketamine is essentially just the active form of ketamine, which is a party drug, and hence there are concerns about the potential for abuse. Overall, many psychiatrists will agree that NICE has been right to exercise caution here.”

https://www.nice.org.uk/guidance/indevelopment/gid-ta10371/consultation/html-content-3

Declared interests

Prof David Curtis: “I have no conflict of interest.”