Esketamine for treatment of depression in Huntington's disease: A case report

Depression and suicidal ideation are common in Huntington's disease (HD). We report a 60-year-old male with HD who suffered from treatment-resistant depression with intermittent suicidal thoughts for 20 years, irritability and apathy. Despite multiple trials of antidepressants, no sustained improvement was achieved. Under nasal esketamine treatment his mood improved dramatically after three treatment days. Beck Depression Inventory (BDI) score dropped from 29 to 5. In a three-month follow-up investigation depression worsened again (BDI score: 20). To our knowledge, this is the first reported case of esketamine use in HD, suggesting that esketamine may be a treatment option for psychiatric symptoms in HD, particularly treatment-resistant depression.