Esketamine
Pronounced
"es-KET-a-meen"
Uses
This medication is used along with an antidepressant taken by mouth to treat depression in adults. Esketamine is thought to work by affecting the balance of a certain natural substance (glutamate) in the brain.
Warning
Esketamine is given in a doctor's office or medical clinic. This medication may cause drowsiness, dizziness, fainting, anxiety, or serious (possibly fatal) slow/shallow breathing. It may also cause you to feel disconnected from your body, thoughts, feelings, space, and time (dissociation). You must be monitored for at least 2 hours after each treatment by a health care professional to make sure these side effects go away and it is safe for you to leave the medical clinic or doctor's office.
This medication also has a risk for abuse and physical and psychological dependence. See also How to Use section.
To receive this medication in the United States, you must understand, agree to, and carefully follow the requirements of the Spravato REMS Program. If you live in Canada or any other country, consult your doctor and pharmacist for your country's regulations.
Antidepressant medications are used to treat a variety of conditions, including depression and other mental/mood disorders. These medications can help prevent suicidal thoughts/attempts and provide other important benefits. However, studies have shown that a small number of people (especially people younger than 25) who take antidepressants for any condition may experience worsening depression, other mental/mood symptoms, or suicidal thoughts/attempts. It is very important to talk with the doctor about the risks and benefits of antidepressant medication (especially for people younger than 25), even if treatment is not for a mental/mood condition.
Tell the doctor right away if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech). Be especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.
How to Use This Medication
See also Warning section.
Read the Medication Guide provided by your pharmacist before you start using esketamine and each time you go for treatment. If you have any questions, ask your doctor or pharmacist.
To reduce the risk of nausea and vomiting, avoid food for at least 2 hours before treatment, and avoid drinking liquids for at least 30 minutes before treatment.
If you have a stuffy nose, ask your doctor if you should use a corticosteroid spray or decongestant drops/spray in your nose at least 1 hour before esketamine treatment.
A health care professional will give you instructions for how to use the nasal spray device. Blow your nose before you start treatment. You may need to use more than one spray device based on your dose. Spray once in each nostril per device. Lean your head back and rest for 5 minutes after using each device. Do not blow your nose right after a dose.
You will be monitored during each treatment and afterward for at least 2 hours. You will need to have someone drive you home after each treatment.
The dosage and treatment schedule are based on your medical condition and response to treatment. Use this medication regularly to get the most benefit from it. To help you remember, mark your calendar with the treatment dates.
If you suddenly stop using this medication, you may have withdrawal symptoms (such as cravings, tiredness, poor appetite, anxiety). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used esketamine for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.
When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.
Tell your doctor if your condition does not get better or if it gets worse.
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