How Can Ketamine Be Administered? 

Ketamine can be administered in a variety of ways, including through:

• Intravenous (IV) infusion
• Intramuscular (IM) infusion
• Oral Tablet or Lozenge
• Nasal Spray

IV and IM injections are the most commonly used methods of administering ketamine for medical purposes. Still, it can also be taken orally in pill form and through the newest form of ketamine administration, a nasal spray called esketamine (Spravato).

How Does Ketamine Nasal Spray (Esketamine) Work?

Esketamine is a nasal spray form of ketamine that was approved by the U.S. Food and Drug Administration (FDA) in 2019 as a treatment for adults with treatment-resistant depression. Esketamine works by binding to glutamate receptors in the brain and blocking their activity, which helps reduce symptoms of depression. Unlike other antidepressants, esketamine has a rapid onset of action, and its effects can be felt within hours after administration. 

Brief History of Esketamine 

Esketamine is derived from ketamine, which was first created in 1962 by Parke Davis & Co., now a part of Pfizer Inc, primarily as an anesthetic. In the mid-1970s, some researchers found that ketamine could also help lift people's moods, acting as an antidepressant. However, because ketamine was also known as a recreational drug with some hallucinogenic effects, people were cautious and didn't fully embrace this discovery.

Fast forward to 2006, when Johnson & Johnson's Janssen Pharmaceuticals saw potential in a part of ketamine called esketamine and decided to study it more closely for treating depression. They worked on it and, in 2017, submitted esketamine to the FDA for approval as a new depression treatment. After reviewing the data and conducting clinical trials, the FDA gave the green light in 2019, making esketamine an approved treatment option for adults struggling with depression that doesn't get better with standard treatments.

Benefits of Ketamine Nasal Spray Versus Other Methods 

The major advantage that esketamine has over other forms of ketamine administration is its rapid onset of action: patients may feel relief from their symptoms within hours after administration compared to days or weeks with other forms of treatment. 

In addition, because it is administered nasally rather than through injection or ingestion, there are usually fewer side effects associated with esketamine than other forms of ketamine. Finally, since esketamine is generally administered at home by patients themselves instead of at a clinic or hospital setting, it is convenient and may be more cost-effective than other methods.

What Is The Effectiveness Of Ketamine Nasal Spray? 

Since the FDA gave the thumbs up to esketamine nasal spray in 2019, many studies have examined how well it works. The news is good: one study found that when people used esketamine nasal spray along with starting a new antidepressant, they tended to feel better than those who only started a new antidepressant and used a placebo spray without esketamine ^[1]. Another study gave us even more hope, showing that around 64% of people felt a significant lift in their mood after using esketamine for four weeks ^[2].

These studies tell us that esketamine can be a powerful tool, especially when used together with other depression treatments, for those who haven't had luck with standard options. If depression has been a long battle, esketamine nasal spray might be the extra help needed to turn the tide.

How Do I Get Started With Ketamin Nasal Spray? 

If you are interested in trying out esketamine as a treatment option for your depression symptoms but don't know where to start, here are some steps you can take: 

1. Talk to your doctor about whether you would benefit from this new therapy option; they will provide you with a prescription for Spravato® nasal spray, which contains esketamine, along with instructions on how to use it safely and effectively.
2. Make sure you understand all the risks involved before beginning any new treatments; be sure to ask your doctor any questions you have about potential side effects.
3. Have someone available who can monitor your progress while taking Spravato®; this person should remain present during each dose until at least 2 hours after completion.
4. Follow all instructions provided by your doctor regarding dosage amount and frequency; keep track of any changes you experience while taking Spravato® so that your doctor can assess your progress accurately over time.
5. If your symptoms aren't improving or are worsening, contact your doctor immediately so they can adjust your dosage accordingly if necessary.

While further research into esketamine's long-term efficacy is needed, current evidence suggests that esketamine may prove beneficial for treating various mental health conditions. Ultimately, it's important to remember that everyone's journey is different, and esketamine is just one option for those on the road to recovery. 

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