Hero # Esketamine for Depression Esketamine is an FDA-approved nasal spray used with an oral antidepressant in certain patients whose depression has not improved enough with other medicines.

Quick facts - Regulatory status: FDA-approved medication in a restricted REMS program. - Used with: An oral antidepressant. - Setting: Certified healthcare setting.

• Monitoring: Two hours after each dose because of sedation and dissociation risks.

What it is Esketamine is the NMDA antagonist listed in the FDA depression-medicines guide. It is intended for patients who have tried other depression medicines that did not work for them.

How it is given Spravato is a nasal spray administered in a healthcare setting certified in the Spravato REMS program. The clinic must monitor the patient for sedation and dissociation for two hours after each dose.

Common side effects FDA lists dissociation, dizziness, nausea, sleepiness, spinning sensation, decreased feeling or sensitivity, and anxiety as common esketamine side effects.

Serious risks and warnings Esketamine can cause temporary sedation, dissociation, and an increase in blood pressure. FDA also notes that it is a federal controlled substance with misuse and abuse potential and that patients should not drive or operate machinery until the next day after a restful sleep.

Who should ask about it Esketamine may be discussed for people whose depression has not improved with other medication treatment. It is typically considered in more specialized or treatment-resistant cases rather than as a first step.

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