Oral esketamine for depression and demoralization in patients with advanced cancer receiving palliative care

Patients with cancer for whom no curative treatment options remain, often experience depression and/or demoralization. Currently available treatments are often unable to diminish these conditions within the remaining time that patients may still have. Esketamine, an N-methyl-D-aspartic acid (NMDA) glutamate receptor antagonist, has shown efficacy as a rapid acting antidepressant in treatment studies on MDD and is hypothesized to constitute an acceptable,effective and rapid treatment option for depression and demoralization in advanced cancer patients.

In this pilot study, we evaluate the feasibility of oral esketamine in the treatment of depression and demoralization in patients with advanced cancer who receive palliative care. We also aim to assess the feasibility of a future trial, based on safety and acceptability of the treatment and feasibility of the study procedures. Patients will receive an oral dose of 0.5 mg (minimum) to 3.0 mg (maximum) esketamine twice per week for a five week period.

Collaboration between UMCG departments of medical oncology and psychiatry.