Ketamine Nasal Spray and Treatment Resistant Depression, Anxiety, PTSD and Chronic Pain
A recent study found that a single dose of IV ketamine can have a quick antidepressant response in patients who have had difficulty treating their depression with other antidepressant medications. The antidepressant effects lasted about a week for the patients, and had fewer side effects than other forms of medical treatment.
This is great news for patients who have experienced treatment-resistant depression, anxiety, PTSD, or chronic pain and have been searching for a way to relieve their symptoms. Many antidepressant medications offer serious setbacks for patients, including taking a long time to start working and low rates of success. But ketamine offers new promise for people suffering from depression or other conditions, especially those who have had trouble finding a drug that worked for them.
“The discovery of ketamine and its unique mechanisms heralds a new era with tremendous promise for the development of novel, rapid, and efficacious antidepressant medications,” wrote Ronald S. Duman, a psychiatrist from Yale University who analyzed the study.
Nasal Spray Adds New Possibilities
Currently, a patient would receive an infusion of the drug from a provider via IV drip. However, one pharmaceutical company, Janssen, has reformulated a derivative of ketamine into a nasal spray form. The drug is molecularly different from ketamine and only contains the L isomer of ketamine.
According to some early trials, Janssen has reported their drug to be an effective antidepressant in nasal spray form. So far, researchers have found that esketamine (Spravato) is not significantly different from ketamine in terms of its effect on depression. But because it would be a patented drug, it offers a more lucrative option to pharmaceutical companies who would want to be able to recuperate the costs of clinical trials in studying its effectiveness and obtaining FDA approval.
Currently, compounded ketamine nasal spray (with both isomers) is available through a prescription. Compounded medications are FDA-approved drugs in other forms or doses.
Injected Ketamine Likely More Effective
The Injection and Infusion Clinic of ABQ is keeping its eye on esketamine as it makes its way to market. While Janssen and other pharmaceutical providers have high hopes for the new nasal spray, Spravato, it’s important to recognize that it is unlikely to be the cure-all that Janssen is promoting it to be. Janssen has not yet announced whether their esketamine nasal spray (Spravato) will be available for at-home administration or if it will be restricted to clinic-only settings. Ketamine and its derivatives are a controlled substance. As such, there are risks when taking it, especially when offered as a take-at-home medication.
Still, if you have treatment-resistant depression, anxiety, PTSD, or chronic pain that has responded to IV ketamine infusions, adding nasal spray could be part of a comprehensive treatment plan. Not all patients are eligible, nor is it recommended in all cases.
In the meantime, low-dose ketamine IV infusions are known to be extremely effective and safe. And while nasal spray likely has its place, it will unlikely be the cure-all Janssen has been promoting it to be.
For more information on this exciting new treatment for depression or to book an appointment, get in touch with us.