Intranasal esketamine for depression: Not so special K

Intranasal esketamine, recently approved for resistant depression, costs around $600 per dose, whereas plain injected ketamine costs less than $20 per dose. Research indicates that intranasal esketamine is less effective and has more unwanted effects than injected ketamine. The approval means this intranasal formulation will now be the form used and researched. While the approval of an inferior treatment mode is understandable given medicine approval processes, careful thought is needed before embracing this particular form of a promising treatment.

Study at a glance

Abstract

Background Intranasal esketamine has been recently approved for the treatment of resistant depression. It is the only form of ketamine approved. The formulation costs around $600 per dose while plain injected ketamine, on which most research has been done, costs less than $20 per dose. Research shows that intranasal esketamine is less effective and has more unwanted effects than injected ketamine, yet the approval means that this intranasal formulation will now be the form used and researched. Conclusion While the approval of an inferior treatment mode is understandable from the processes by which medicines are approved, we should think carefully about embracing this particular form of a promising treatment.