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Esketamine: What You Should Know

Esketamine is a medication that has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression, particularly treatment-resistant depression (TRD). It is a form of ketamine, which is an anesthetic agent used for decades in medical settings. Esketamine is administered intranasally as a nasal spray and acts as a rapid-acting antidepressant.

One of the key advantages of esketamine is its rapid onset of action. Unlike traditional antidepressant medications that may take weeks or even months to alleviate depressive symptoms, esketamine can produce a noticeable improvement in mood within hours or days. This rapid response can be crucial for individuals experiencing severe depression or those who have not responded to other treatments.

For individuals who have not responded well to traditional antidepressants or have experienced intolerable side effects, esketamine provides an alternative treatment option. It expands the range of possibilities for managing depression, particularly in cases where other treatments have been unsuccessful.

Esketamine is an NMDA receptor antagonist, meaning it blocks the activity of a specific receptor in the brain called the N-methyl-D-aspartate (NMDA) receptor. By modulating this receptor, esketamine influences the release of certain neurotransmitters, such as glutamate, which is involved in mood regulation.

Esketamine is primarily used in the treatment of depression. It is specifically approved for treatment-resistant depression, which is defined as depression that has not responded adequately to at least two previous antidepressant treatments.

Esketamine is administered as a nasal spray under the supervision of a healthcare professional in a clinical setting. The nasal spray allows for quick absorption of the medication through the nasal passages into the bloodstream and then to the brain.

Esketamine treatment typically involves two phases: induction and maintenance. During the induction phase, patients receive esketamine twice weekly for the first four weeks, followed by a gradual reduction in frequency. In the maintenance phase, the frequency of esketamine administration is adjusted based on the individual’s response and clinical judgment.

Esketamine treatment requires close monitoring due to potential side effects and safety concerns. Patients are required to remain under observation at the treatment site for about two hours. To ensure patient safety, healthcare professionals monitor blood pressure and pulse before and after treatment.

Common side effects of esketamine can include dissociation (a sense of detachment from surroundings), dizziness, sedation, increased blood pressure, and increased heart rate. These effects are generally temporary and resolve soon after treatment. Serious side effects, though rare, can occur and should be discussed with the prescribing physician.

Esketamine is typically used as part of a comprehensive treatment approach for depression, which may include psychotherapy, medication, and other therapeutic interventions. It is important to note that esketamine is not a stand-alone treatment for depression but is used in conjunction with other treatments.

Esketamine treatment is only available through certified treatment centers or clinics. It is important to consult with a qualified psychiatrist or healthcare professional to assess the suitability of esketamine treatment and to determine the most appropriate treatment plan for an individual’s specific needs.

It’s crucial to consult with a healthcare professional to discuss the potential benefits, risks, and considerations of esketamine treatment, and to determine if it is an appropriate option based on an individual’s unique circumstances and treatment history.