A drug called ketamine is used to make esketamine, which is also used for treating depression. However, esketamine, a more potent version of ketamine, has only recently been approved by the FDA for use in nasal sprays to treat depression that is resistant to treatment.
 
As a derivative of ketamine, esketamine is derived from part of the molecule. The more potent it is, the lower the dose and the fewer side effects you are likely to experience. The treatment is more likely to be covered by insurance companies now that it’s available in an intranasal form and approved by the FDA.

Like ketamine, esketamine distorts perception during the first two hours after administration, so it must be administered in a clinic. Esketamine nasal spray is treated as an outpatient procedure.
 
In order to use the nasal spray, you must give yourself three doses, five minutes apart, under the supervision of a doctor. Until potential side effects have subsided, you remain in the clinic under a doctor’s observation.
 
The use of esketamine must be accompanied by the use of a conventional antidepressant. It is hoped that esketamine will provide rapid relief from depression symptoms until the other medication takes effect.

In addition to being highly effective depression treatments, esketamine and its related drug ketamine offer a number of advantages.
 
The mechanism of esketamine’s antidepressant action differs from that of other drugs. Chemicals naturally occurring in the brain such as serotonin, norepinephrine, and dopamine are increased by conventional antidepressants. Communication between brain cells is relayed by these chemicals. According to theory, brain cells communicate more effectively with each other when there is a greater supply of these neurotransmitters.
 
The effects of esketamine are similar to those of other antidepressants, but it increases glutamate levels, the brain’s most abundant chemical messenger. This results in a greater impact on a greater number of brain cells at the same time.

For adults with treatment-resistant depression, Spravato is the first nasal spray medication available. You may have treatment-resistant depression if you’ve taken at least two antidepressants and still have depressive symptoms. Spravato contains esketamine which facilitates its use for treatment-resistant depression.
 
Patients with treatment-resistant depression can currently take esketamine. If you have tried at least two other antidepressants and did not experience remission or a 50% improvement in mood after those two treatments, you must have tried at least two additional antidepressants. With esketamine, people who have not been successful with other antidepressants can experience what it’s like to live without depression. The right treatment gives them hope that they can feel better.
 
It is common for antidepressants to take a long time to act. People with depression often feel better after several weeks or more of treatment. Esketamine, on the other hand, immediately impacts brain cells, providing relief from depression within hours.
 
The use of conventional antidepressants may actually increase suicidal thoughts in children and young adults at the beginning of treatment. Only esketamine, a drug commonly prescribed for bipolar disorder, has been proven to reduce suicidal thoughts. The FDA is considering approving esketamine for this purpose, despite the fact that it is not currently approved.
 
According to research, untreated depression causes long-term brain damage and increases the risk of dementia. According to studies, depression can cause a 20% shrinkage of the hippocampus, a region of the brain that plays a crucial role in memory and learning. Esketamine, however, may counteract depression’s harmful effects.
 
Approximately 33% of people with depression won’t respond to more than one type of conventional antidepressant. The majority of patients in clinical trials who received esketamine reported a reduction in depression symptoms. For treatment-resistant depression, the only other approved drug therapy is a combination of fluoxetine and olanzapine (an antipsychotic). It is important to note, however, that this treatment has significant long-term effects, including weight gain, metabolic changes, diabetes, and hypertension.
 
Esketamine therapy is available at Psychiatry Unplugged. We are conveniently located at 6801 Park Terrace, Suite 530B Los Angeles CA 90045. For more information, call us or book an appointment online. We serve patients from Los Angeles CA, Beverly Hills CA, Santa Monica CA, Encino CA, and Pacific Palisades CA.