FDA approves Esketamine in the U.S.; sleep apnea surgery reduces risk of car accidents; adults of divorced parents more likely to have strokes – Morning Medical Update

Author(s):

Austin Littrell

Key Takeaways

Esketamine nasal spray is the first monotherapy approved for treatment-resistant depression, showing rapid symptom improvement and addressing unmet patient needs.
Surgery for obstructive sleep apnea significantly reduces motor vehicle accident risk compared to CPAP or no treatment, offering an effective option for select patients.
Adults with childhood parental divorce have a 60% higher stroke risk, persisting after adjusting for traditional risk factors, warranting further investigation.

The top news stories in medicine today.

Spravato (esketamine) approved in the United States

The U.S. Federal Drug Administration (FDA) has approved esketamine (Spravato; Johnson & Johnson) CIII nasal spray as the first and only monotherapy for adults with treatment-resistant depression (TRD), marking a milestone in mental health treatment. Backed by a priority review, the approval is based on clinical data demonstrating rapid and significant improvement in depressive symptoms compared to placebo, as early as 24 hours, with sustained benefits through four weeks. Johnson & Johnson emphasized the importance of this approval for addressing the unmet needs of patients with TRD, a condition affecting one-third of individuals with major depressive disorder (MDD) who do not respond to oral antidepressants. Read more from Patient Care Online.

Sleep apnea treatment reduces risk of car accidents

Surgery for obstructive sleep apnea (OSA) significantly lowers the risk of motor vehicle accidents (MVAs) compared to use of a Continuous Positive Airway Pressure (CPAP) device or receiving no treatment at all, according to a study published in Otolaryngology–Head and Neck Surgery. Analyzing more than 2.8 million patients, researchers found accident rates were 3.4% for surgery patients, 6.1% for CPAP users and 4.7% for untreated individuals. Surgical treatment reduced accident odds by 45% compared to CPAP, and 21% compared to no treatment at all, underscoring its potential as an effective option for select patients with sleep apnea.

Adults who experienced parental divorce as children may be at higher risk of stroke

Older Americans who experienced parental divorce as children have 60% higher odds of stroke compared to peers whose parents did not get divorced, according to researchers from the University of Toronto, Tyndale University and the University of Texas at Arlington. The study, published in PLOS One, analyzed more than 13,000 respondents aged 65 and older, researchers found that one in nine adults with divorced parents reported having a stroke, compared to one in 15 of those whose parents had not divorced during their childhood. Notably, the association persisted even after considering traditional risk factors, including smoking, physical inactivity, lower income and education, diabetes, depression and low social support.

“While these types of survey-based studies cannot establish causality, we are hoping that our consistent findings will inspire others to examine the topic,” said Esme Fuller-Thompson, a professor at Factor-Inwentash Faculty of Social Work and director of the Institute of Life Course and Aging at the University of Toronto.