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Published on June 21, 2019

spraying nasal spray

Newly Approved Medication May Help People With Depression

As the most disabling condition worldwide – more than 300 million humans face it – major depressive disorder can not only impact quality of life, it can be fatal when untreated.

It’s a disease that also can develop treatment resistant tendencies. Medications that make one person’s depression manageable may provide no help at all for others.

That’s why the FDA approval of a new nasal spray that helps treatment-resistant depression sufferers is being seen as another tool for managing this mental and emotional health concern.

“Spravato or esketamine is a novel anti-depressant treatment approach, and it’s the most unique medication to receive approval in many years,” said Meredith Powell, MD, psychiatrist with Avera Medical Group University Psychiatry Associates in Sioux Falls.

What it Is and Is Not

When people see the generic name of the drug, they may notice that it includes an anesthetic’s name in it – ketamine.

“Ketamine is composed of esketamine and arketamine, and this new treatment contains only esketamine,” said Powell. “They are different on a molecular level as well as how they affect a person. There are ongoing clinical trials investigating use of ketamine for treatment of depression, but this has not been approved by the FDA. Esketamine has.”

Patients soon will be able to receive esketamine, but it is only for patients with depression for whom two other medications have not worked or only provided partial response.

“This new approach is also different in that it works more quickly and unlike many other anti-depressant medications, it is administered through a nasal spray in the clinic under the guidance of a provider,” she said. “It can only be given in facilities that have a certified provider, a certified clinic and a certified pharmacy as well.”

Additional Choices for Patients

Avera Behavioral Health Center in Sioux Falls has met those conditions and will likely begin prescribing esketamine this year. Patients take the spray and they remain at the clinic for two hours afterward. Patients typically get two doses per week for four weeks; then a single spray each week for another four-week period.

“This medication is shown to help people after one dose is administered, and that is a big difference from current antidepressant medications which take several weeks to provide relief or for a person to notice a difference,” said Powell. “After the initial two phases, patients would likely take it once a week, or once every/other week, depending on how their depression responds.”

Powell said that while the drug will not provide relief for all depression sufferers, it may be a tool for those who have not found relief through traditional talk therapy or more established medications.

“This is not a guaranteed treatment, but for persons suffering with major depressive disorder who have had other medications prove to be insufficiently effective, it could prove to be a difference-making drug,” Powell said.

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