Recently, the Food and Drug Administration approved esketamine (Spravato – a brand name of a nasal spray that uses the esketamine drug) as a medication for treatment-resistant depression.
Since ketamine is one of its main components, Spravato assists in restoring synaptic connections in the brain. This method is different from how conventional antidepressants treat depression. Because of this, ketamine and esketamine can provide fast relief for depression symptoms.
Ketamine and esketamine are different from common antidepressants, which makes them unique from others. It’s essential to learn about them, what they are, how they’re administered, what makes them different, and which one is best for treating your depression.
What are Ketamine and its Method of Administration?
Ketamine is an anesthetic drug that has been used to cure anesthesia for over 40 years. This drug was used on battlefields or as a veterinary drug. But for depression, this drug is administered in smaller doses compared to the dose administered for anesthesia.
This kind of ketamine is called racemic ketamine. It is a combination of “R” and “A” ketamine. It was recently approved by the FDA to be used as anesthesia, but is not yet approved as a cure for depression.
Additionally, the American Psychiatric Association discovered that there is insufficient information on using ketamine to cure MDD and TRD. There is not enough information because ketamine is old, and not too many companies have decided to invest millions of dollars in clinical trials for ketamine to be used as an antidepressant.
Ketamine is usually given intravenously because of how it works. It won’t be as effective if administered orally because it metabolizes too fast.
Although the intravenous method has proven to yield robust and rapid effects, patients have to be subjected to treatment at least three times a week. This process can be difficult, inconvenient, and costly for patients because IV lines are connected to their veins every time they come for treatment.
What is Esketamine (Spravato), and its Administration Method?
Esketamine (Spravato) is another version of ketamine. It is a nasal spray medication (meaning that it’s administered intranasally) that works rapidly and produces results.
It is also the recently-approved drug for patients who experience depression symptoms, or have been struggling with depression and have tried other medications to no avail.
Esketamine is considered safe for use by different studies. A study by Papakostas in 2020, where esketamine was administered to 774 people, shows that patients who received the intranasal esketamine treatments experienced a better result than those who received a placebo.
Standard antidepressants can increase thoughts of suicide at the beginning of treatment, especially in young ones. Spravato is the only drug that has proven to decrease thoughts of suicide, the only drug that comes close is lithium which is usually administered for bipolar disorder.
How Does the Different Ways of Administration Between Ketamine and Esketamine Affect You?
Both ketamine and esketamine are very effective drugs, but esketamine appears to be more potent. This is a primary reason why it’s administered in lower doses. And only qualified doctors are allowed to administer these drugs to reduce the potential side effects. If not adequately monitored and controlled, these drugs can be very addictive.
Ketamine has to be given to the patients intravenously at least thrice a week. The process of administering this drug is usually very inconvenient for the patients. The patient will have to endure new IV injections every time they return to the doctor for treatment. Apart from this, ketamine is not yet approved by the FDA as a treatment for resistant depression. Although some people use it, it’s off the records.
Esketamine (Spravato) is given to a patient strictly under a doctor’s supervision. The drug is administered in 3 doses, with about 5 minutes intervals in between. Then you continue to remain under the doctor’s watch for the next 2 hours until the coast is clear and all risk of potential side effects has passed.
Due to the potency of these drugs, they have some side effects that could affect a patient if not administered in the proper doses. These side effects include:
- Nausea
- Drowsiness
- Increased blood pressure
- Dissociation
- Headache
When these side effects kick in, they last for about 40 minutes before they elapse, usually happening within two hours of using the drugs. The side effects are more serious, especially after the first two treatment sessions.
There has been no report directly comparing the potency and effectiveness of ketamine and esketamine. Both ketamine and esketamine have proven effective as antidepressant drugs; ketamine alone has proven to have over 70% success rate, and ketamine has been approved for treatment-resistant depression.
