Esketamine

Esketamine

Esketamine2DCSD

Introduction

Esketamine, marketed under the brand name Spravato among others, is a medication utilized both as a general anesthetic and for the treatment of treatment-resistant depression. A derivative of ketamine, esketamine is administered via nasal spray or injection into a vein. Recognized for its rapid action and part of a new class of antidepressants, esketamine represents a significant advancement in psychiatric medicine, especially for patients unresponsive to traditional antidepressants.

Chemical structure of Esketamine.

History

Esketamine was introduced for medical use in 1997, primarily as an anesthetic. Its development was based on ketamine, an established anesthetic, focusing on one of its enantiomers for enhanced therapeutic benefits. In 2019, esketamine was approved in the United States for use with other antidepressants for adults with treatment-resistant depression, marking a milestone in the treatment of severe depressive disorders.

Medical Uses

Esketamine is primarily used for:

• Treatment-resistant depression in adults, in combination with oral antidepressants.
• Induction of anesthesia, particularly in settings where rapid onset and short duration of action are required.

Mechanism of Action

Unlike traditional antidepressants that target the monoaminergic system, esketamine acts on the NMDA receptors in the brain. This action modulates glutamate, a neurotransmitter associated with mood and cognition, potentially leading to rapid improvements in depressive symptoms.

Administration Methods

Esketamine is administered through two main routes:

• Nasal Spray: For psychiatric use, providing a non-invasive and rapid method of administration.
• Intravenous Injection: Used in anesthetic applications, offering fast action suitable for medical procedures.

Benefits

Esketamine's approval was based on its unique benefits, including:

• Increased potency compared to ketamine.
• Faster onset of antidepressant effects.
• Potential for patients who have not responded to other treatments.

Side Effects

While esketamine is a promising treatment, it may cause side effects such as dissociation, dizziness, nausea, sedation, and increased blood pressure. Its use is closely monitored to manage these risks effectively.

See Also

• Ketamine
• Treatment-resistant depression
• NMDA receptor antagonist

References

• "Esketamine for Treatment-Resistant Depression." New England Journal of Medicine, 2019.
• "Safety and Efficacy of Esketamine for the Treatment of Major Depression." American Journal of Psychiatry, 2019.

External Links

• FDA: Esketamine Information
• Official Spravato (esketamine) website

Esketamine Resources
Need Help Finding a Doctor? Need help finding a doctor or specialist anywhere in the world? Explore our world directory. WikiMD's DocFinder can assist you in locating millions of physicians.	Medical Knowledge Access the latest research - Most recent articles Ongoing trials.

Translate to: East Asian 中文, 日本, 한국어, South Asian हिन्दी, Urdu, বাংলা, తెలుగు, தமிழ், ಕನ್ನಡ,
Southeast Asian Indonesian, Vietnamese, Thai, မြန်မာဘာသာ, European español, Deutsch, français, русский, português do Brasil, Italian, polski