Esketamine Does Not Live Up to Hopes for a More Convenient Ketamine

Eskatmine (brand name Spravato) is a new nasal spray that works like ketamine. To treat depression, ketamine has been delivered through an IV or breathed in as a nebulizer treatment. The idea of a nasal spray has been very appealing to many. It sounds more convenient, but after the FDA approval process, it really hasn’t turned out that way.

IV Ketamine is a Life Saver

It’s true. IV Ketamine has proven to be a life saver for countless patients with treatment-resistant depression, PTSD, and severe bipolar disorder. People are regaining their creativity, vitality, and thirst for life. Where traditional anti-depressants can take weeks to work, IV ketamine often creates significant relief within 4 to 72 hours of the first treatment. Esketamine is supposed to work the same way. It probably doesn’t, but that’s a topic for a different post.

How Long Are IV Ketamine Visits?

If you’ve done your research, you’re probably thinking, “Yes, but IV ketamine is such a time investment.” There are several infusion treatments over the first few weeks. Each treatment visit lasts about 90 minutes. And later maintenance visits may be needed every 30 to 60 days.

That is a time investment. It’s certainly more work than taking a pill. But we mostly prescribe ketamine for patients who are not getting the needed results from other antidepressants. When it’s a question of getting your life back, 90 minutes per month is well worth the time investment.

Will Spravato Nasal Spray be More Convenient?

Short answer, “No.” Not even close. Spravato nasal spray will probably take more time than IV ketamine. The FDA did not approve Spravato for home use. Instead, to get Spravato, patients have to make an appointment with a doctor, just like with ketamine.

Guidelines recommend that patients stay in the office for two hours of monitoring after the treatment. That’s longer than a typical IV ketamine visit. What’s more, Spravato doses are not as effective, so people must visit more often. Spravato needs two visits per week for one month. After that, Spravato needs maintenance visits as often as weekly. In the maintenance phase, Spravato visits take longer and they are needed as much as eight times more often!

Ketamine treatments at the Charlotte Ketamine Center are more convenient than Spravato treatments.

Author

Neal Taub, MD, Medical Director Neal Taub, MD Dr. Taub received his medical degree from Baylor College of Medicine in Houston Texas after graduating Magna Cum Laude from the University of California. He has been invited to present or publish his work on more than 15 occasions at conferences such as the American College of Rehabilitation Medicine and the Association of Academic Physiatrists. Dr. Taub has served as the medical director for CMC - Mercy Rehabilitation Center, Meadowhaven Rehab and Specialty Care Center, and American Transitional Care. He also founded and currently serves as the medical director for The Taub Group in Charlotte, NC. Dr. Taub's honors include winning the P/SL Foundation Grant for medical research and the Lewis Leavitt Award for Physical Medicine and Rehabilitation. Dr. Taub is certified by the American Board of Physical Medicine & Rehabilitation.