Esketamine Nasal Spray Is A Newly Approved Solution for Treatment-Resistant Depression

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Esketamine Nasal Spray Is A Newly Approved Solution for Treatment-Resistant Depression
Anxiety and depression disorders are the most common mental illnesses in the US. They are affecting over 40 million adults aged 18 and older every year. 
Despite the fact that anxiety disorders are highly treatable, less than half of those suffering receive treatment. Specialists suggest that depression and anxiety could develop from a complex set of risk factors. Genetics, brain chemistry, personality, and unfortunate life events can all trigger depression to occur. The prevalence of depressive episodes was higher among adult females compared to males. There are several differences in the manner in which depressed moods manifest based on age and sex. Depression in men usually manifests in tiredness, irritability, and anger. On the other hand, specialists have noticed that women’s depressed moods evolve into sadness, worthlessness, and guilt.

Treatment-Resistant Depression

The most popular theory that aims to explain the development of depression in individuals is based on the fact that it may be caused by low brain levels such as neurotransmitters. Serotonin and norepinephrine are neurotransmitters which are associated by the brain with feelings of happiness and well-being. Yet, recent studies show that the neurotransmitters may not be the only cause of it. This suggested to specialists that antidepressants which aim to increase serotonin and norepinephrine levels may not be a treatment that works for every individual suffering from depression. As traditional antidepressants only affect neurotransmitters, it may be the reason why some patients do not respond positively to them. Treatment-resistant depression is a challenge to the field of clinical psychiatry.  Almost half of the individuals who suffer from major depressive disorder experience treatment resistance.  It is often linked with suicidal ideation and suicide attempts. The current antidepressant treatments play an invaluable role as they fail to relieve the symptoms of depression. Those individuals struggling with the major depressive disorder which is treatment-resistant do not respond to treatments. This condition makes them battle with persistent feelings of sadness, sleep disturbances, low energy, and, eventually, deep thoughts of death and suicide. Specialists cannot provide exact data to explain why some individuals experience treatment-resistant disorders and others do not. However, they have observed that women and senior citizens are struggling with TRD at higher rates. The reasons behind the vulnerability to antidepressant treatments can stand behind biological and psychological factors, as well as overall health which can also play a major role in it.

Rapidly-Acting Treatments

The National Institute of Mental Health has funded a research project which promotes the development of quicker and innovative therapies for treatment-resistant depression. Specialists have noticed that current existing antidepressant medications usually take up to a few weeks to reduce the symptoms of depression and suicidality in patients. Moreover, some patients suffer from a major depressive disorder which does not fully responds to the existing treatments. Trouble is that severe depression can become life-threatening if not treated. Usually, the patients who suffer from it start developing suicidal thoughts which resulted in several suicidal attempts.  Recent studies show worrying results that estimate that over 50 per cent of individuals in the US who die by suicide suffer from major depression. Although the best way to prevent suicide is the early detection and treatment of depression, some patients diagnosed with depression do not respond positively to the current existing treatments. The urgent need for faster and more efficient antidepressant treatment has made researchers consider ketamine as a viable solution for individuals who suffer from a treatment-resistant major depressive disorder. The drug has been proven to have a significant positive effect in reducing the symptoms of depression within hours.

What Is Esketamine?

Ketamine is a drug which has hallucinogenic effects and is used illegally. It is a short-acting drug which induces euphoria, sustained pain relief, and sedation mixed with powerful hallucinogenic effects. Yet, although ketamine and esketamine are perceived to be practically the same thing, they work differently especially due to the way they are administered. Both ketamine and esketamine aim to bump up levels of feel-good brain chemicals called serotonin. Yet, esketamine targets glutamate which is a neurotransmitter that sends messages across the brain.  Various clinical trials have proven that esketamine is up to ten times more effective than any current antidepressant treatment currently existing.

The side-effects of Spravato nasal spray

Before approval, the intranasal esketamine was tested several times and has proved to be generally well tolerated. Yet, due to the risk of various adverse outcomes and the potential abuse or misuse of the drug, the newly approved esketamine nasal spray is only available through a restricted distribution.  There are a few common side effects experienced by the patients who were part of the controlled clinical trials and treated with Spravato. The most common side effects were including disassociation, dizziness, vomiting, nausea, lethargy, and increased blood pressure. All patients were constantly monitored during the clinical trials and the treatment with the esketamine nasal spray was either interrupted or reduced depending on the side effects experienced by the patients. Yet, the long-term safety study conducted by the specialists has shown that Spravato nasal spray was generally well tolerated by the patients. Although electroconvulsive therapy (ECT) was proven to be a faster-acting antidepressant method, it comes with several risks of cognitive side effects. That is why researchers have made significant efforts to discover a better solution to help individuals struggling with treatment-resistant depression. After a long-standing need for additional and more efficient treatments for treatment-resistant depression, The U.S. Food and Drug Administration has approved Spravato, the esketamine nasal spray. FDA has conducted several controlled clinical trials to determine the efficacy and safety of this drug. Due to safety concerns, the drug will only be available through a restricted distribution system as it must be administrated in a certified medical environment where the patient can be monitored. Yet, it is a promising solution for patients who were struggling with major depressive disorder episodes. The newly approved esketamine intranasal spray has rapid effects on reducing the symptoms of major depressive disorder. Usually, within 24 to 48 hours, the symptoms of depression are reduced in patients. These rapid effects of Spravato are a promising solution for helping patients at high risk of committing suicide or self-harm. If you or a loved one is suffering from any form of addiction or depression then take the first step and seek help, call us on 0203 955 7700 where one of our experts can point you in the right direction.

About Author

Nicholas Conn

Nicholas Conn

Nicholas Conn is a leading industry addiction expert who runs the UK’s largest addiction advisory service and is regularly featured in the national press, radio and TV. He is the founder and CEO of a drug and alcohol rehab center called Help4addiction, which was founded in 2015. He has been clean himself since 2009 and has worked in the Addiction and Rehab Industry for over a decade. Nick is dedicated to helping others recover and get treatment for drug and alcohol abuse. In 2013, he released a book ‘The Thin White’ line that is available on Amazon.

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