Depresión mayor resistente. Terapia electroconvulsiva versus esketamina. ¿Cuál debería ser el orden? A propósito de un caso

Abstract

We present a case of a 73-year-old woman with a treatment- resistant depression to several antidepressants and electroconvulsive therapy, who improved significantly with intranasal esketamine showing a decrease in the MADRS score from 43 points (severe depression) to 18 points (mild depression) after 4 months of treatment. These results raise the question of whether, in elderly patients suffering a treatment- resistant depression and suicidal ideation, we should choose either electroconvulsive therapy or intranasal esketamine.