Esketamine
Depressive Disorder, Treatment-Resistant
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Drug Status
Government Approvals
US(FDA)
WHO Essential Medicine
NO
Known Teratogen
No
Pharmaceutical Class
NA
Controlled Drug Substance
YES
Summary
Esketamine is used to treat treatment-resistant depression, which is a type of depression that doesn't improve with standard treatments. It helps improve mood and reduce symptoms of depression, offering a new option for those who haven't found relief with other therapies.
Esketamine works by blocking NMDA receptors, which are involved in mood regulation. This action increases certain neurotransmitters, which are chemicals that help transmit signals in the brain, leading to improved mood and reduced depressive symptoms.
Esketamine is usually given as a nasal spray under medical supervision. The starting dose is determined by your doctor based on your condition. It's important to follow your doctor's instructions and not alter the form of the medication.
Common side effects of esketamine include dizziness, nausea, and sedation, which is a feeling of being sleepy or tired. These effects can vary in severity and frequency among individuals.
Esketamine can cause sedation and dissociation, which is a feeling of being disconnected from reality. It may increase blood pressure and has potential for abuse. It's not recommended for those with aneurysmal vascular disease, which involves abnormal blood vessel dilation, or arteriovenous malformation, which is an abnormal connection between arteries and veins.
Indications and Purpose
How does esketamine work?
Esketamine works by blocking NMDA receptors in the brain, which are involved in mood regulation. This action helps increase the levels of certain neurotransmitters, which are chemicals that transmit signals in the brain, leading to improved mood and reduced depressive symptoms. Think of it like adjusting the volume on a radio to improve the sound quality. Esketamine provides a new approach to treating depression, especially for those who haven't responded to other treatments.
Is esketamine effective?
Esketamine is effective for treatment-resistant depression, which is a form of depression that doesn't respond to standard treatments. Clinical studies show that esketamine can rapidly reduce depressive symptoms in some patients. It is used in combination with an oral antidepressant. The effectiveness of esketamine varies among individuals, and your doctor will monitor your response to the treatment to ensure it is working for you.
What is esketamine?
Esketamine is a medication used to treat treatment-resistant depression. It belongs to a class of drugs called NMDA receptor antagonists, which work by affecting certain chemicals in the brain to improve mood. Esketamine is administered as a nasal spray under medical supervision. It is used in combination with an oral antidepressant to enhance its effectiveness. Esketamine offers a new option for patients who haven't responded to other treatments.
Directions for Use
For how long do I take esketamine?
Esketamine is used for treatment-resistant depression and is typically part of a long-term treatment plan. The duration of use depends on your response to the medication and your doctor's guidance. It's important to follow your doctor's instructions and not stop taking esketamine without medical advice. Your doctor will monitor your progress and adjust the treatment plan as needed to ensure its effectiveness and safety.
How do I dispose of esketamine?
To dispose of esketamine, bring unused medicine to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of it properly to prevent harm to people or the environment. If you can't find a take-back program, you can throw it in the trash at home. Mix it with something undesirable like used coffee grounds, seal it in a plastic bag, and throw it away.
How do I take esketamine?
Esketamine is usually administered as a nasal spray under the supervision of a healthcare provider. The frequency and dosage depend on your specific condition and doctor's instructions. It's important not to crush or alter the form of esketamine. Follow any dietary or beverage restrictions provided by your healthcare provider. If you miss a dose, contact your doctor for guidance. Always follow your doctor's specific advice about using esketamine.
How long does it take for esketamine to start working?
Esketamine can start working within hours of administration, providing rapid relief of depressive symptoms. However, the full therapeutic effect may take several weeks. Individual factors, such as your overall health and response to treatment, can affect how quickly you notice improvements. It's important to follow your doctor's instructions and attend regular check-ups to monitor your progress and adjust the treatment plan as needed.
How should I store esketamine?
Store esketamine at room temperature, away from moisture and light. It doesn't need refrigeration. Keep it in its original packaging to protect it from damage. Avoid storing it in humid places like bathrooms, where moisture can affect its effectiveness. Always store esketamine out of children's reach to prevent accidental ingestion. Check the expiration date regularly and properly dispose of any unused or expired medication.
What is the usual dose of esketamine?
The usual starting dose of esketamine for adults is determined by your doctor based on your condition. Esketamine is typically administered under medical supervision, often starting with a lower dose that may be adjusted. The maximum recommended dose and any adjustments for special populations, such as the elderly, will be guided by your healthcare provider. Always follow your doctor's specific dosing instructions.
Warnings and Precautions
Can esketamine be taken safely while breastfeeding?
Esketamine is not recommended while breastfeeding due to limited information on its safety. It's unclear if esketamine passes into human breast milk, but animal studies suggest it might. This raises concerns about potential effects on a baby's developing brain. If you're taking esketamine and want to breastfeed, talk with your doctor about safer medication options that would allow you to nurse your baby safely.
Can esketamine be taken safely while pregnant?
Esketamine is not recommended during pregnancy due to limited evidence on its safety. Animal studies suggest potential risks, but human data is lacking. Uncontrolled depression during pregnancy can cause serious problems for both mother and baby. If you're pregnant or planning to become pregnant, talk with your doctor about the safest way to manage your depression. They can help create a treatment plan that protects both you and your baby.
Can I take esketamine with other prescription drugs?
Esketamine can interact with other medications that affect the central nervous system, such as benzodiazepines, which are used for anxiety, and opioids, which are pain relievers. These interactions can increase sedation and the risk of respiratory depression, which is slowed breathing. Always inform your doctor about all medications you take to avoid potential interactions. Your doctor can adjust your treatment plan to ensure safety and effectiveness.
Does esketamine have adverse effects?
Adverse effects are unwanted reactions to a medication. Common adverse effects of esketamine include dizziness, nausea, and sedation. These effects vary in frequency and severity. Serious side effects can include increased blood pressure and dissociation, which is a feeling of being disconnected from reality. If you experience any adverse effects, inform your doctor. They can help manage these effects and adjust your treatment if necessary.
Does esketamine have any safety warnings?
Esketamine has important safety warnings. It can cause sedation and dissociation, which is a feeling of being disconnected from reality. These effects require monitoring after administration. Esketamine may increase blood pressure, so it's important to monitor this during treatment. Not adhering to these warnings can lead to serious consequences, such as increased risk of accidents or cardiovascular issues. Always follow your healthcare provider's instructions.
Is esketamine addictive?
Esketamine has the potential for abuse and dependence. It affects brain chemistry, which can lead to psychological dependence. Warning signs include cravings or using more than prescribed. To prevent dependence, use esketamine only as directed by your healthcare provider and discuss any concerns about addiction with them. They can provide guidance on safe use and monitor for any signs of dependence.
Is esketamine safe for the elderly?
The elderly are more vulnerable to safety risks of medications due to age-related changes in the body. Esketamine can be used in the elderly, but with caution. They may experience increased sedation or dizziness, which can lead to falls. Close monitoring by a healthcare provider is important. Discuss any concerns with your doctor, who can adjust the treatment plan to ensure safety and effectiveness for elderly patients.
Is it safe to drink alcohol while taking esketamine?
It's best to avoid alcohol while taking esketamine. Alcohol can increase the sedative effects of esketamine, leading to increased drowsiness and impaired coordination. This combination can be dangerous and increase the risk of accidents. If you choose to drink occasionally, limit your alcohol intake and be aware of any increased sedation. Talk with your doctor about alcohol use while taking esketamine for personalized advice.
Is it safe to exercise while taking esketamine?
You can exercise while taking esketamine, but be cautious. Esketamine can cause dizziness or sedation, which might affect your balance and coordination during physical activity. To exercise safely, start with light activities and gradually increase intensity. Stay hydrated and listen to your body. If you feel dizzy or lightheaded, stop exercising and rest. Consult your doctor if you have concerns about exercising while on esketamine.
Is it safe to stop esketamine?
Stopping esketamine suddenly can lead to withdrawal symptoms or worsening of your condition. It's important to follow your doctor's guidance when discontinuing esketamine. They may suggest gradually reducing the dose to minimize withdrawal effects. Always talk with your doctor before stopping esketamine to ensure a safe transition and to maintain your health condition.
What are the most common side effects of esketamine?
Side effects are unwanted reactions to a medication. Common side effects of esketamine include dizziness, nausea, and sedation. These effects can vary from person to person. If you notice new symptoms after starting esketamine, they might be temporary or unrelated to the medication. Talk with your doctor before stopping any medication. They can help determine if the side effects are related to esketamine and provide guidance.
Who should avoid taking esketamine?
Esketamine should not be used if you have an allergy to it or its ingredients. It is contraindicated in individuals with aneurysmal vascular disease, which is a condition involving abnormal blood vessel dilation, or arteriovenous malformation, which is an abnormal connection between arteries and veins. Caution is needed in patients with a history of substance abuse. Always consult your doctor about any concerns before using esketamine.
