Description

KETAMINE (ESKETAMINE) NASAL SPRAY

KETAMINE NASAL SPRAY OVERVIEW

Esketamine nasal spray is made from a drug called ketamine, an anesthetic that has also been used for many years to treat depression. But it wasn’t until recently that ketamine, a more potent version of ketamine, earned FDA approval specifically for use as a nasal spray for those with treatment-resistant depression.

Esketamine is derived from part of the ketamine molecule,” says Kaplin, who has studied the drug for three years. “Because it’s more potent, you can use it at a lower dose and theoretically have fewer side effects. Now that it’s available in an intranasal version and approved by the FDA, it’s more likely that insurance companies will cover the treatment.

Esketamine nasal spray is used together with an antidepressant taken by mouth, to treat patients with depression who have previously received at least 2 antidepressant treatments that did not work well (treatment-resistant depression).

Esketamine nasal spray is also used together with an antidepressant taken by mouth, to treat depressive symptoms in patients with major depressive disorder (MDD) with suicidal ideation or behavior.

Ketamine nasal spray is a form of ketamine, a generic drug that’s been used as a form of anesthesia for many years,

KETAMINE NASAL SPRAY FOR DEPRESSION

Esketamine, and its related drug ketamine, are highly effective depression treatments for a number of reasons:

Esketamine’s antidepressant function works through a different mechanism than other drugs. Conventional antidepressants increase levels of naturally occurring chemicals such as serotonin, norepinephrine, and dopamine. These chemicals are messengers that relay communication between brain cells. The theory is that having greater quantities of these neurotransmitters allows for better communication between brain cells and positively affects mood.

Esketamine works in a similar fashion, but unlike other antidepressants, it increases levels of glutamate, the most abundant chemical messenger in the brain. The result? A greater impact on more brain cells at one time.

DOSING OF KETAMINE NASAL SPRAY

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For nasal dosage form (solution):
  • For depressive symptoms in patients with major depressive disorder (MDD) with suicidal ideation or behavior:
    • Adults—84 milligrams (mg) 2 times per week for 4 weeks. Your doctor may adjust your dose as needed and tolerated it.
    • Children—Use and dose must be determined by your doctor.
  • For treatment-resistant depression (TRD):
    • Adults—The starting dose is 56 milligrams (mg) on Day 1, followed by 56 or 84 mg taken 2 times per week on Weeks 1 to 4. Then, 56 or 84 mg is taken once a week on Weeks 5 to 8, followed by 56 or 84 mg taken every 2 weeks or once a week on Week 9 and after. Your doctor may adjust your dose as needed and tolerated it.
    • Children—Use and dose must be determined by your doctor.

ADVERSE REACTIONS OR SIDE EFFECTS OF KETAMINE NASAL SPRAY

The most common symptoms associated with ketamine nasal spray include dizziness, nausea, sedation, lethargy, disassociation, vertigo, hypoesthesia, anxiety, increased blood pressure, vomiting, and feeling drunk. Physicians should closely monitor patients for at least two hours following administration.

Ketamine increases blood pressure and heart rate. Physicians should monitor blood pressure before administration and for at least two hours following administration.

In some cases, antidepressant agents increase the risk of suicidal thoughts and actions in young adults, especially during the initial treatment period. Esketamine nasal spray may increase suicidal thoughts and actions, especially in patients with a history (or family history) of depression. Physicians should closely monitor patients for worsening depressive symptoms.

Ketamine is a controlled substance that has the potential for dependence (physical and psychological) and abuse. The physician should assess patients for the risk of abuse and misuse before prescribing ketamine nasal spray. Physicians should monitor patients for signs of abuse throughout the treatment program.

This is not an all-inclusive list of the side effects of ketamine nasal spray. Side effects are typically felt shortly after administering ketamine nasal spray and generally resolve the same day.

Chronic misuse of ketamine has been associated with impaired cognitive processing speed, verbal fluency, verbal learning, verbal memory, and visual recognition memory.

STORAGE OF KETAMINE NASAL SPRAY

Store this medication at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond-use date. Do not flush unused medications or pour them down a sink or drain.

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