ketamine Nasal Spray
Ketamine has also been used for years in smaller doses in IV form for patients with treatment-resistant depression. But as a generic drug, it has not been put through the FDA’s review process for that use. Ketamine nasal spray
It’s actually a controlled substance (it is sometimes abused as a recreational drug — you may have heard it called Special K). Because of that, and because it can create feelings of dissociation and hallucination in people who take it, the new esketamine nasal spray will only be administered in a doctor’s office or hospital setting.
“It’s a slightly different form of ketamine and will be given as nasal puffs, but the effects are essentially the same,” Dr. Anand says.A patient will go to their doctor once or twice a week to get nasal puffs of a dose of esketamine. Because they may experience disorientation or confusion immediately afterward, they will stay at the doctor’s office for two hours. They are also advised not to drive, operate machinery, or undertake a task that requires similar mental effort for the rest of the day.
One potential benefit of the new drug is that it’s fast-acting. People may notice a relief in symptoms within just a few hours, and it could last for several days, Dr. Anand says. Most oral antidepressants, on the other hand, can take weeks to start working.
That’s because it works in a different way from other depression drugs. “Whereas most other available antidepressants work mainly on the serotonin, norepinephrine or dopamine systems, ketamine has major effects on glutamate, which is a different neurotransmitter that is much more prevalent in the brain,” Dr. Anand says.
Beyond potential side effects, ketamine does have additional drawbacks. Though it has been used safely as a short-term anesthetic and in lower doses as a short-term antidepressant, doctors don’t yet understand whether it’s safe and effective to use over many months or years.
“This drug affects a major neurochemical in the brain, and if you interfere with that long-term, we’re not sure what the effects of that are going to be,” Dr. Anand says. “It’s also a drug of addiction, and people can misuse it or overuse it.”