Virtual reality mindfulness added to usual esketamine care for hard-to-treat depression

A Pilot Randomised Controlled Study Evaluating the Efficacy and Tolerability of Virtual Reality-Based Mindfulness as an Adjunct to Treatment as Usual in Treatment-Resistant Depression

Not applicable Interventional Hospital Universitari Vall d'Hebron Research Institute · NCT07422519

This will test whether adding a virtual-reality mindfulness program to usual esketamine treatment helps adults with treatment-resistant depression feel less depressed.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment30 (estimated)
Ages18 Years to 74 Years
SexAll
SponsorHospital Universitari Vall d'Hebron Research Institute Academic / other
Locations1 site (Barcelona)
Trial IDNCT07422519 on ClinicalTrials.gov

What this trial studies

This interventional study compares a combined virtual reality (VR)-based mindfulness intervention plus standard esketamine treatment to esketamine treatment alone in adults with treatment-resistant major depressive disorder. Participants receive the pharmacological induction and maintenance schedule of intranasal esketamine while one group also undergoes guided VR mindfulness sessions as an adjunct. Outcomes include changes in depressive symptom severity, inflammatory blood markers, mindfulness trait measures (FFMQ-SF), tolerability and adverse events, and duration of remission up to six months after treatment. The trial recruits eligible adults at Hospital Universitari Vall d'Hebron and follows them through treatment and follow-up assessments.

Who should consider this trial

Good fit: Adults aged 18–74 with treatment-resistant major depressive disorder who have failed at least two antidepressants and one augmentation or combination strategy are the intended participants.

Not a fit: Patients with contraindications to esketamine, those currently in another interventional antidepressant trial, or those with medical or psychiatric conditions that would interfere with participation are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, adding VR mindfulness to esketamine could reduce depressive symptoms and help sustain remission longer than medication alone.

How similar studies have performed: Esketamine has demonstrated efficacy in TRD and mindfulness or VR interventions have shown promising results in smaller studies, but the specific combination of VR mindfulness plus esketamine is relatively untested in larger controlled trials.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Age between 18 and 74 years, inclusive
* Diagnosis of treatment-resistant Major Depressive Disorder (MDD), single or recurrent episode, in accordance with DSM-5 diagnostic criteria.
* Inadequate response to two or more oral antidepressants during the current depressive episode
* Inadequate response to at least one pharmacological combination or augmentation strategy
* Ability and willingness to provide written informed consent for participation and data collection

Exclusion Criteria:

* Presence of any contraindication to esketamine administration according to the approved product label
* Current participation in another interventional clinical study involving antidepressant medication
* Any medical, psychiatric, or other condition that, in the opinion of the investigator, could: (a) compromise participant safety or well-being, or (b) interfere with, limit, or confound study assessments or outcomes

Where this trial is running

Barcelona

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Depression - Major Depressive DisorderDepression DisorderDepression ChronicTreatment-Resistant Major Depressive DisorderTreatment-Resistant DepressionMajor Depressive DisorderMindfulness-Based InterventionVirtual Reality
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.