What is the most important information I should know about esketamine?
Esketamine is an NMDA (N-methyl-D-aspartate) receptor antagonist used to treat adults withtreatment-resistant depression(TRD).
It is the first FDA-approvedpsychedelic medicineand the second drug approved to treat TRD.
To be considered for this treatment, patients must have tried at least two other antidepressants without success.
Most oral antidepressants need weeks or even months to take effect.
Clinical trials suggest that esketamine nasal spray can significantly reduce symptoms in as little as 24 hours.
Esketamine vs. Ketamine
Esketamine is derived fromketamine, a powerful anesthetic.
Two of these studies demonstrated that esketamine rapidly reduces depressive symptoms in people with TRD.
The other positive study was the maintenance study which assessed relapse prevention.
Data from this trial showed that esketamine reduces relapse rates.
Despite decades of research, themolecular mechanisms underlying depressionare poorly understood.
Consequently, scientists arent exactly certain how esketamine reduces depression.
What is clear is that it is fast-acting.
Within hours, people may experience changes to the brain that reducesymptoms of depression.
Before Taking Esketamine
Esketamine should never be used as a first-line of treatment.
Precautions and Contraindications
Esketamine is not appropriate for everyone.
People should not breastfeed while undergoing treatment.
Individuals who are in crisis may need a fast-acting drug that can offer immediate relief.
But esketamine isnt the only option for individuals with TRD.
You will give yourself the nasal spray while being supervised by a healthcare professional.
Each gadget contains 28 milligrams (mg) and delivers two sprays.
During this time, your healthcare provider will closely monitor you for adverse reactions.
When it is safe for you to leave, you will need someone to drive you home.
Modifications
The safety and efficacy of esketamine have not been established for pediatric use.
Guidelines for use among people 65 and older are the same as those for other adults.
Side Effects of Esketamine
Like any new treatment, manufacturers will continue to monitor any adverse reactions.
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor.
If you or a loved one are in immediate danger, call 911.
For more mental health resources, see ourNational Helpline Database.
Drug Interactions
Esketamine can interact with a number of other medications and supplements.
Esketamine also has the potential for misuse and can cause physical dependence.
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