The US Food and Drug Administration (FDA) approved the first-ever anti-depression nasal spray, Spravato.
The pharmaceutical company Johnson & Johnson created the spray from esketamine, a more potent version of ketamine.
Spravato doesn’t work for everyone, but it can be life-changing to some.
How does the anti-depression nasal spray work?
The FDA has expanded approval for a nasal spray known as Spravato, a brand name for #esketamine, to treat people with severe #depression. Dr. Yvette I. Sheline noted how esketamine differs from existing drugs for depression. https://t.co/nJ8M0Kd9lk
— Penn Medicine (@PennMedicine) January 24, 2025
Johns Hopkins Medicine says Spravato boosts serotonin, norepinephrine and dopamine levels, similar to regular antidepressants.
However, this new medicine increases glutamate, the most abundant chemical messenger in the brain.
As a result, the anti-depression nasal spray has a greater impact on more brain cells than conventional antidepressants.
It’s available as a monotherapy, but Johns Hopkins says patients must take it with a conventional antidepressant.
Esketamine should only provide rapid relief from depression symptoms until other medications take effect.
The first dose can distort a patient’s perception. That’s why they take the initial dose in a clinic, and doctors must observe them for two hours.
Then, the patient takes three doses of the anti-depression nasal spray every five minutes under a doctor’s supervision.
The patient remains in the clinic under observation until potential side effects have subsided.
Side effects include hallucinations, feelings of being disconnected from reality, and headaches.
If esketamine seems familiar, that’s probably because it’s a component of ketamine. It was once popular as a party drug called Special K.
Fortunately, Spravato underwent 31 clinical trials over the past six years and a phase 4 trial, which approved it for monotherapy use.
“Treatment-resistant depression can be very complicated, especially for patients who do not respond to oral antidepressants or cannot tolerate them,” said Johnson & Johnson neuroscientist Bill Martin.