ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Mood Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1678119
This article is part of the Research TopicBridging the Gap: An Interdisciplinary Perspective on Ketamine in Psychiatric Disorders - Volume IIIView all 3 articles
The Perspectives of Patients with Depression toward Esketamine, and the Influence of their Medication Adherence on their Viewpoints: A Saudi Cross-Sectional Study
Provisionally accepted
Ahmad H. Almadani1*
Ayedh H. Alghamdi1
Fahad B. Alfahad2Abdullah S. Alibrahim3Abdulrahman I. Binbakhit3Ziyad B. Alenazi3Lama M. Alruwaili3Abdulrahman A. Alshahwan3Abdullah K. Muhnna3
Mohammed A. Aljaffer1- 1Department of Psychiatry, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- 2Department of Psychiatry, Eradah Mental Health Hospital, Al Kharj, Saudi Arabia
- 3College of Medicine, King Saud University, Riyadh, Saudi Arabia
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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
Received: 01 Aug 2025; Accepted: 08 Oct 2025.
Copyright: © 2025 Almadani, Alghamdi, Alfahad, Alibrahim, Binbakhit, Alenazi, Alruwaili, Alshahwan, Muhnna and Aljaffer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ahmad H. Almadani, ahalmadani@ksu.edu.sa
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