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27 May 2022

NICE rejects esketamine for treatment-resistant depression

National Institute for Health and Care Excellence (NICE) has rejected the use of esketmine for treatment-resistant depression for the third time.

Esketamine is said to work by changing brain chemicals responsible for mood, combatting feelings of depression in a matter of hours. 

Marjorie Wallace, Chief Executive of SANE, comments on the decision:

“For the last 30 years we have been waiting for innovations in the field for the most serious and debilitating mental illnesses such as treatment-resistant depression.

“It is therefore a huge disappointment that NICE, unlike other countries such as the United States, is depriving some of the most desperate patients of any chance to be freed from the anguish they and their families suffer.

“Like the SSRI antidepressants so freely handed out (which have barely changed in their efficacy and side-effects since first being prescribed in the late 1980s), or talking therapies, treatment is only effective in a percentage of patients. SANE is contacted by many for whom neither approach has helped them sufficiently.

“What we believe is important about new interventions such as esketamine is that their efficacy can be judged within a few short days, and therefore does not leave people for months taking drugs to which they may not be responding.

“Unlike in other areas of medicine we have little in our armoury to combat major depressive disorder. The real shame is that we are rejecting one of the very few innovations in treating this condition.”

Read the Final Guidance from NICE at

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