Nasal Spray Depression Treatment

Esketamine nasal spray is a prescription medicine, used along with an antidepressant to treat adults with treatment-resistant depression (TRD) and depressive symptoms in adults with major depressive disorder (MDD) who need fast relief.

Esketamine nasal spray is approved for treatment-resistant depression (TRD) in conjunction with an oral antidepressant. It is also FDA approved for major depressive disorder (MDD) with suicidal thoughts and behavior.

Esketamine nasal spray works by temporarily blocking certain receptors in the brain called glutamate receptors. This blockage causes brain cells to produce more glutamate which helps brain cells grow new connections. It is the only medication approved with this type of mechanism of action. It has shown to work faster than traditional antidepressants to help people with treatment resistant depression.

Yes, esketamine nasal spray is an adjunctive or add-on treatment which means you add it to your antidepressant(s) for better results.

There are two phases to treatment.

1. Induction Phase
Spray is administered twice a week for 1-4 weeks.
Dosage is 56 or 84 mg each time.

2. Maintenance Phase I
Spray is administered once a week from week 5 to Week 9.
Dosage is 56 or 84 mg each time

3. Maintenance Phase II
Spray is administered every other week after 9 weeks and up to one year.
Dosage is 56 or 84 mg each time.

Treatment is individualized based on response to treatment. Some people may need more or different schedule. And, some people may need only 1-2 months of treatment

• First, you'll arrive at the office 30 minutes prior to each treatment session. Please refrain from eating 2 hours before the sessions and avoid drinking liquids 30 minutes beforehand. You can take your regular medications with a sip of water, but it's recommended to hold any benzodiazepine medications (Xanax, Ativan, Klonopin, Valium etc.) on the day of treatment.

• Next, you receive the medicine through nasal spray administration and are closely monitored by both the provider and trained health care professionals for two hours in a safe, calming environment located within our office. Your vital signs are checked periodically throughout the treatment session. Plan to allocate 2 - 3 hours for each visit to the office.

• Patients undergoing treatment often report feeling relaxed and comfortable. We encourage patients to follow up with their therapists regularly after treatment sessions for best results.

• Also, you must agree to and follow treatment recommendations. You’ll need a friend or family member to accompany you and drive you home after each treatment session, as it’s advised not to operate heavy machinery or drive on the day of treatment. You will remain in the office until released by the health care provider.