March 19, 2019

Spravato Nasal Spray Approved for Depression

12 March 2019, 05:52 | Randall Craig

Ketamine is a medicinal and veterinary anaesthetic Credit Bob London Alamy Stock

Ketamine which can be injeted for medical purposes

The drug's active ingredient is s ketamine a derivative of ketamine. The nasal spray will carry the FDA's most stringent safety warning. Here & Now's Jeremy Hobson speaks with Dennis Charney, dean of the Icahn School of Medicine at Mount Sinai in NY. "It really has opened up a whole new way of thinking about depression", Gerard Sanacora, professor of psychiatry at Yale University School of Medicine and director of the Yale Depression Research Program, said of ketamine.

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Spravato is a chemical mirror image of anesthetic ketamine, which is abused as a recreational party drug that goes by the street name Special K.

Nevertheless, many hope that this new treatment will be a step in the right direction for mental health in the United States. Patients who have treatment-resistant depression reported "rapid and sustained improvement" of symptoms.

Esketamine, developed by Johnson & Johnson, will be administered as a nasal spray and be used in conjunction with an oral antidepressant. Spravato is meant to treat patients who have major depressive disorder (MDD) and have not responded "adequately" to two at least two different types of antidepressants.

But esketamine presents some challenges because of its similarities to ketamine. By the second month, a patient will receive treatment once a week or every two weeks, which will reduce the cost to between US$2,3000 and US$3,500 per month.

Data so far indicates that esketamine is safe to use, "but it has to be used in a very well-regulated way to prevent issues related to addiction/substance use", Dr. Hwang says. The medication will not be dispensed directly to patients for home use. "It will only be available in approved and certified treatment centers". In a long-term study, patients in stable remission taking the medication who continued treatment with the medicine were 51% less likely to relapse versus those who maintained a regimen of a placebo and an oral antidepressant. The spray has been approved as an alternative for people resistant to other types of treatments.

Esketamine seems to help alleviate depression by acting on the NMDA/glutamate receptor, which is different from more recently popular antidepressants.

Johnson & Johnson said the wholesale cost of each treatment with ketamine will range from $590 to $885, depending on the dose.

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