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Description

Ketamine nasal spray, sometimes referred to as intranasal esketamine, is used as a nasal spray to treat patients with treatment-resistant depression (TRD) and major depressive disorder (MDD). The main type of ketamine used is SPRAVATO (Esketamine) CIII nasal spray, which is administered in combination with an oral antidepressant.

What is esketamine treatment like?

Esketamine like ketamine, has the potential to distort your perception during the first two hours after treatment, so it has to be administered in a clinical setting. Treatment for esketamine nasal spray is done on an outpatient basis.

With the nasal spray, you give yourself three doses, spaced five minutes apart, under doctor’s supervision. You remain in the clinic under doctor observation until potential side effects have passed.

Esketamine must be used in conjunction with a conventional antidepressant. The intention is that esketamine provides rapid relief from depression symptoms until the other medication takes effect.

How does esketamine treat depression?

Esketamine, and its related drug ketamine, are highly effective depression treatments for a number of reasons:

Esketamine’s antidepressant function works through a different mechanism than other drugs. Conventional antidepressants increase levels of naturally occurring chemicals such as serotonin, norepinephrine, and dopamine. These chemicals are messengers that relay communication between brain cells. The theory is that having greater quantities of these neurotransmitters allows for better communication between brain cells and positively affects mood.

Esketamine works in a similar fashion, but unlike other antidepressants, it increases levels of glutamate, the most abundant chemical messenger in the brain. The result? A greater impact on more brain cells at one time.

People with Depression Get Rapid Relief
Common antidepressants are slow-acting. It often takes several weeks to make a noticeable difference in how people with depression feel, says Kaplin. On the other hand, esketamine immediately impacts brain cells, offering relief from depressive symptoms within hours.

Esketamine Decreases Suicidal Thoughts
Conventional antidepressants may actually increase suicidal thoughts at the beginning of treatment, especially in children and young adults. Esketamine is the only drug besides lithium, a drug commonly prescribed for bipolar disorder, that’s proven to decrease suicidal thoughts, says Kaplin. Although esketamine isn’t currently approved for this purpose, the FDA is considering it.

It’s Effective for Treatment-Resistant Depression
Up to 33% of people with depression don’t respond to multiple kinds of conventional antidepressants. Esketamine reduces depression symptoms in a majority of these people in clinical trials.

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