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Esketamine nasal spray is a fast-acting medication that is administered through the nose. It is a form of ketamine, which is a popular anesthetic medication used in surgery. Esketamine is a form of ketamine that has been modified to target the receptors in the brain that are involved in regulating mood.The cost of Spravato, which contains the active ingredient esketamine, in Canada varies depending on a number of factors such as dosing and duration of treatment. Generally speaking, the cost can range from hundreds to thousands of dollars per treatment session. The Canadian Agency for Drugs and Technologies in Health (CADTH) has recommended that Spravato be used as a second-line therapy for adults with treatment-resistant depression who have failed at least two other antidepressants. In terms of availability, patients are able to obtain an esketamine nasal spray prescription through a licensed physician or clinic. There are some online pharmacies that offer the medication for purchase; however, it is important to exercise caution when purchasing medications online and ensure that the source is legitimate and reputable.

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What is esketamine

Spravato is a nasal spray medication containing esketamine that was approved by the FDA for treatment of persistent depression in adults. It is the first of its kind and the only NMDA receptor antagonist to receive FDA approval. Ketamine infusions are a successful treatment option for 70% of patients with treatment-resistant Major Depressive Disorder.

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Esketamine mechanism of action

Esketamine is a drug that treats depression differently than traditional antidepressants. It works by blocking NMDA receptors in the brain and increasing levels of glutamate, which is the most abundant chemical messenger in the brain. This activates AMPA receptors, releasing other molecules that help brain cells communicate with each other along new pathways, likely affecting mood, thought patterns, and cognition.

Benefits and Risks of Esketamine Nasal Spray

Potential Benefits of Esketamine Nasal Spray

Esketamine nasal spray has been shown to be an effective treatment for TRD in adults. It works quickly and can alleviate symptoms of depression within hours or days, compared to traditional antidepressants that can take weeks to start working. It can also improve suicidal ideation and help people with TRD maintain symptom relief.

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Difference between ketamine and esketamine

Esketamine (Spravato) is a more potent version of ketamine used to treat depression. It allows for lower doses and potentially fewer side effects. Both are controlled substances and can be highly addictive. Ketamine must be given intravenously up to three times per week, which can be inconvenient and painful. In contrast, Esketamine (Spravato) is administered in an outpatient setting under supervision, with three doses spaced five minutes apart. Patients remain under supervision for two hours to monitor potential side effects.

Esketamine side effects include:

Nausea
Drowsiness
Increased blood pressure
Dissociation (sometimes called out-of-body experiences)
Headache

The side effects tend to peak at 40 minutes and wear off within two hours of treatment. You can expect the most intense side effects during the first two treatment sessions.

Esketamine Nasal Spray Frequently Asked Questions

Who should NOT take esketamine Nasal Spray ?

Do not use Esketamine Nasal Spray if you are allergic to esketamine, ketamine, or any of its ingredients, or if you have an aneurysm, arteriovenous malformation, or history of bleeding in the brain. Inform your healthcare provider if you have heart, brain, or liver problems, psychosis, or are pregnant or planning to become pregnant. You should not take SPRAVATO® if pregnant or breastfeed while taking it. Inform your healthcare provider of all medications you take, including vitamins and herbal supplements.

How will I know if esketamine working?

Your healthcare provider will regularly ask about your depression symptoms, side effects, and improvement while taking SPRAVATO®. They use a standardized rating scale to track your progress. It’s important to ask your provider how they will evaluate your response to treatment and how you can assist with that. If you switch providers, ensure they are communicating with your referring provider about your progress.

What to expect after taking Esketamine Nasal Spray ?

Esketamine therapy can produce various side effects, including hallucinations and feeling detached from oneself or reality. These effects typically reach their maximum intensity within 40 minutes of treatment, but usually subside within two hours.

What are some rules regarding Esketamine Nasal Spray ?

You will use Esketamine Nasal Spray twice a week for four weeks while taking another antidepressant. Do not stop without talking to your healthcare provider. Continuing treatment will be decided after four weeks. Possible side effects include prolonged drowsiness, mental changes, and high blood pressure.

What happens when you stop taking Esketamine Nasal Spray ?

Esketamine withdrawal symptoms include craving, fatigue, poor appetite, and anxiety. Dependence should be monitored post-treatment. Patients may feel excessively sleepy after receiving esketamine treatment.

How long does Esketamine Nasal Spray stay in your system?

It rapidly declines in your system after the first 2-4 hours but it can take 6-12 hours before it or its metabolites are completely out.

How to get esketamine nasal spray for anxiety

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