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Esketamine (Spravato)

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Esketamine (Spravato) explained

Esketamine (Spravato) is an intranasal NMDA receptor antagonist for treatment‑resistant depression and MDD with acute suicidal ideation/behavior; administered under REMS supervision.

FDA Approved

Esketamine (Spravato) helps treat

• Treatment‑resistant depression (with oral antidepressant)
• MDD with acute suicidal ideation/behavior

additional medications

• Optimize oral antidepressants
• Psychotherapy
• ECT/TMS for refractory depression

medication risks

• Sedation and dissociation (boxed warnings)
• Transient BP increases
• Abuse/misuse potential
• Suicidality warning

side effects

• Dissociation
• Dizziness
• Nausea
• Increased blood pressure
• Somnolence
• Headache

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FAQs

Q: How is esketamine given?
A: As a supervised intranasal spray in a REMS program clinic.

Q: How fast does it work?
A: Some patients feel effects within hours; maintenance is required.

Q: Side effects session‑day?
A: Dissociation, increased BP, sedation—monitor for several hours.

Q: Abuse potential?
A: Schedule III—controlled access via REMS.

Q: Can I drive afterward?
A: No—avoid driving until the next day after restful sleep.

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