Nasal spray could help those who have no success with available depression treatments

Recently, the U.S. FDA approved esketamine, a fast-acting drug derived from the anesthetic, ketamine, that is intended to aid the treatment-resistant population of people with depression.

There are about 16.2 million Americans who suffer from major depression, and as many as a quarter of them reported achieving little to no results from available treatments, including FDA approved drugs and therapy.

Source: Janssen Pharmaceuticals

The pain-reliever, ketamine, has been used for decades as an anesthetic for patients who will undergo surgery. But during the 1990s, it was adopted as a street drug by the underground rave culture for the out-of-body and hallucinogenic sensations that it gives to the user. It was popularly known back then as “Special K”.

More recently, doctors have administered ketamine to people with depression, but the costs for these treatments are usually out-of-pocket due to the lack of FDA approval for the generic anesthetic.

But now, Janssen Pharmaceuticals, a pharmaceutical company under Johnson & Johnson, developed esketamine as a nasal spray designed to treat depression faster than any other conventional treatments such as anti-depressants, which take two or more weeks before it takes effect. The nasal spray, which will be marketed under the name Spravato, is reported to show benefits after only four hours.

Source: Everyday Health

Esketamine will likely be covered under most insurance plans and although it has similar side effects with the generic ketamine, these are thought to be less dramatic.

Dr. Gerard Sanacora, professor of psychiatry at Yale University and director of the Yale Depression Research Program, told NBC News:

“This offers an extremely important, new treatment for people suffering with treatment-resistant depression.”

We know that if you don’t respond to the first two standard classes of antidepressants, the chances of you responding to a third or fourth reduces significantly, so this drug which has a completely different mechanism of action is particularly effective for those who have no standard treatment.”

He also said that this drug will be highly beneficial to those patients who have imminent thoughts or risks of hurting themselves and those who want to shorten their hospital stays.

The newly approved drug is recommended to be taken twice a week for four weeks, with boosters as needed, along with one of the commonly-prescribed oral antidepressants. Doses are required to be taken in a doctor’s office or clinic. Patients should be monitored for at least two hours after administration and their experiences must be recorded in a registry. They are also not allowed to drive on the day of treatment.

There has not been any new FDA approved drugs for depression for 30 years until esketamine came. What doctors usually prescribe are Prozac or similar drugs which enhance serotonin levels in the brain. They are mildly effective, but results take up to weeks or months before they manifest.  For many patients, it also provides no relief from their depression.

As for Ketamine and Janssen’s new drug, it works by targeting the chemical glutamate that is responsible for restoring brain connections, therefore, aiding in the relief of depression.

Spravato – one of the new FDA approved drugs that treat depression – based on the results of a study showing that those patients who were treated with the drug experienced significant improvement in their depression levels than patients who were taking placebo treatments.

Robin Prothro, 60, has been on antidepressants for 20 years. She’s tried five different types of anti-depressants and none of them had ever worked for her.

She enrolled in the Spravato trial two years ago and says that her depression has lifted. It also helped her get back to doing her hobbies such as gardening. She takes Spravato every two weeks at her psychiatrist’s office.

She says that it definitely is a “strong drug”.

I just let the drug work. I close my eyes and my mind is amazingly quiet.”, she says.

Depression is among the leading causes of disability in the US and one of the diseases monitored by authorities because of the rising suicide rates in the nation. Sanacora reminds that: “Esketamine isn’t to be used in place of Prozac. This is meant to be used alongside standard treatments and not instead of standard treatments. We want people to use the medicine responsibly and rationally.”

For more information about this new advancement in the treatment of depression, please watch the video below:

[If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK) or go to for a list of additional resources. Here’s what you can do when a loved one is severely depressed.]

(Note: This article is for informational purposes only and not to be treated as professional opinion or diagnosis.)

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