The perspectives of patients with depression toward esketamine, and the influence of their medication adherence on their viewpoints: a Saudi cross-sectional study
Background: Nasal esketamine has demonstrated efficacy in the management of treatment-resistant depression and psychiatric emergency due to major depression. This study investigates acceptance and awareness of esketamine as a depression treatment option, focusing on factors that influence patients’ acceptance, including adherence to current medication regimens, regardless of
prior esketamine exposure. Methods: This cross-sectional study surveyed 283 adults with depression using a questionnaire and the Medication Adherence Rating Scale (MARS-10). Results: 52.3% of participants were willing to receive esketamine, and 51.2%
preferred its weekly or biweekly dosing over daily antidepressants; 79.5% reported cost as a potential barrier. Common concerns included medication unavailability (59.7%), fear of addiction (50.5%), anticipated stigma (24.4%), and first-month dosing frequency (21.2%). Regarding adherence, 77.4% were nonadherent to their current psychiatric medication regimen. Adherence to the current regimen was higher among patients with previous esketamine use (p <.001) and among those who had someone to stay with them during and after treatment (p = .047). Conclusion: Patients are open to esketamine but have concerns that must be addressed. It also highlights non-adherence as a significant issue in patients with depression. These findings highlight the importance of patients’ education, family involvement, and logistical supports.
KEYWORDS: depression, esketamine, medication adherence, perspectives, Saudi Arabia
CITATION: Almadani AH, Alghamdi AH, Alfahad FB, Alibrahim AS, Binbakhit AI, Alenazi ZB, Alruwaili LM, Alshahwan AA, Muhnna AK and Aljaffer MA (2025) The perspectives of patients with depression toward esketamine, and the influence of their medication adherence on their viewpoints: a Saudi cross-sectional study. Front. Psychiatry 16:1678119.
doi: 10.3389/fpsyt.2025.1678119
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