Pharmacology Corner: Esketamine (Spravato)-A New Novel Medication to Treat Depression-But With a Strong Warning.
Journal of Addictions Nursing October 1, 2019 William J Lorman
Esketamine (Spravato), a nasal spray formulation of the NMDA receptor antagonist ketamine, was approved by the FDA in March 2019 for treatment-resistant depression in adults, to be used alongside an oral antidepressant. About one third of patients with major depressive disorder are treatment resistant to current antidepressants, and depression in bipolar disorder also responds poorly to them. Esketamine must be administered under direct healthcare provider supervision, with blood pressure monitoring before and after dosing, and patients observed for at least 2 hours. To reduce nausea and vomiting, patients should avoid food for 2 hours and liquids for 30 minutes before administration.