Esketamine Treatment for Depression: An Option for Relief

When depression doesn’t let up, it can feel exhausting and isolating. You may be doing everything you can — going to therapy, taking medication and trying to get through each day — and still not feeling like yourself. Esketamine treatment may be an answer for you.

For some adults with hard-to-treat symptoms, esketamine treatment offers a different path. Unlike traditional antidepressants that can take weeks to work, esketamine treatment may begin easing symptoms much sooner. For people who have been carrying the weight of depression for a long time, that possibility can matter.

What Is Esketamine Treatment for Depression?

Esketamine treatment is a FDA-approved prescription nasal spray for adults ages 18 and older with the following:

• Treatment-resistant depression (i.e., people whose depression has not improved after trying two or more oral antidepressants)
• Major depressive disorder with suicidal thoughts or behavior

What makes esketamine treatment different is how it works in the brain. Traditional antidepressants often take weeks to improve symptoms. Esketamine treatment works through a different pathway and may help some people feel better as early as 24 hours after treatment.

This treatment may also be used as part of a broader care plan that includes an oral antidepressant. Some patients may also benefit from other therapies as recommended by their doctor.

Benefits of Esketamine Treatment

For some people, esketamine treatment offers benefits that can feel especially meaningful when depression has disrupted daily life. It’s a different treatment approach for depression that hasn’t improved over time. Potential benefits include: 

• Rapid symptom relief
• Outpatient care (no hospitalization)
• No anesthesia

What To Expect During Treatment

Esketamine treatment takes place in a medical office. During your visit, a provider shows you how to use the nasal spray, which you administer yourself under supervision. Afterward, you stay for at least two hours so the care team can monitor you for side effects and make sure you are safe and comfortable.

During the observation period, you can rest, read, listen to music or watch TV. Because treatment can cause drowsiness or a sense of detachment (feeling disconnected from your mind, body or surroundings), you’ll need someone to drive you home. You should avoid work, school or other demanding activities for the rest of the day.

Treatment often starts twice a week for four weeks. After that, your doctor may decrease visits to weekly or every other week, depending on how your symptoms improve.

Can You Take Antidepressants During Esketamine Treatment?

Yes. For many patients, esketamine treatment is used along with an oral antidepressant.

Side Effects

Esketamine treatment can cause side effects, including: 

• Detachment
• Dizziness
• Drowsiness
• Increased blood pressure
• Nausea
• Vomiting

Because of these possible side effects, treatment is always given under medical supervision.

Ketamine vs. Esketamine: What Is the Difference?

People often hear the terms ketamine and esketamine used together, but they are not the same. Esketamine is a specific form of ketamine that is available as an FDA-approved prescription nasal spray. Ketamine itself is FDA approved as an anesthetic, but it’s not FDA approved as a treatment for depression. This difference matters because FDA approval helps guide how a treatment is studied, prescribed and monitored. 

Is Esketamine Treatment Right for Your Depression?

Living with depression can make it hard to imagine feeling better. But if your symptoms haven’t improved with standard treatment, it may be time to ask about other options. Esketamine treatment is not right for everyone, but for some adults it can offer faster relief and renewed hope.

If you’re exploring next steps for depression treatment, talk with a trusted provider about whether esketamine treatment may be part of your mental health care plan.