Esketamine is an Intranasal Form of Ketamine Therapy

Have you spoken with your psychiatrist lately about how your treatment for severe depression is not working? Major depression affects more than your mood: You may struggle to take care of your physical health, manage your school or work responsibilities, and plan for your future.

Though selective serotonin reuptake inhibitors such as sertraline and paroxetine are traditional pharmaceutical treatments for severe depression, they may not work well enough to relieve your most prominent symptoms. Consider esketamine therapy, a new, FDA-approved intranasal medication for treatment-resistant depression.

What is esketamine?

Ketamine was a medication originally used as an anesthetic during the Vietnam War era. It was then used in emergency rooms as a treatment for patients with suicidal thoughts and severe depression. It is also used as a street drug because it causes euphoria and dissociative feelings (like being outside of one's body) in high doses.

It is thought that ketamine works to help the brain form new synapses by stimulating the N-methyl-D-aspartate, or NMDA, receptors in the brain. Esketamine is a form of ketamine that is available for use in your psychiatrist's office in an intranasal form.

What should patients know about using intranasal esketamine to treat depression?

Many people with severe, treatment-resistant depression are not aware that there are additional treatments they can try once they have exhausted their medication options and different types of therapy. Esketamine therapy should be considered for these patients for the following reasons:

It can provide quick symptom relief 

According to the Psychiatric Times, intranasal esketamine provides swifter relief of symptoms when compared to SSRIs and other traditional treatments. Many patients who have not experienced relief from medications have noticed a dramatic difference within the first few weeks. SSRI therapy, in contrast, can take up to six weeks to take effect.

It is usually covered by insurance

If you have insurance, there is good news: It will probably pay for your esketamine therapy. Now that this medication has been approved by the FDA for treatment-resistant depression, you have a higher chance of getting approved for reimbursement. Speak to your psychiatrist to determine whether your insurance will cover your treatment and whether esketamine nasal spray is the feasible option for your type of depression.

It may be more difficult to administer

Esketamine therapy is not available for at-home use yet, but it may be in the future. Now, you will have to go to your psychiatrist's office, use the nasal spray, and wait while your doctor and his or her staff monitor your vital signs for the next two hours. This procedure is put in place to ensure your safety as ketamine can cause side effects such as cognition changes and dissociation for a little while after you use it.