Have you been suffering from depression for a long time? Perhaps you have tried several medications prescribed by your doctor, but you have not felt the desired improvement. Today we are talking about a special treatment that can help those who suffer from severe depression and do not respond well to other treatments. This is the Esketamine Nasal Spray.
What is Esketamine?
Simply put, Esketamine is a medication used to treat depression. But it is not a common medication given to everyone. Doctors usually prescribe this medication when other antidepressant medications have not helped . It is a nasal spray . One of the popular names for it in the market is Spravato.
This medication may also be used for other conditions besides depression. You can talk to your doctor about this for more information.
Things you need to tell your doctor before taking this medicine
It is very important to tell your doctor about your complete health history before starting this treatment. Do not hide even a minor illness you have. This medicine is not suitable for everyone. If you have any of the conditions below, be sure to tell your doctor about it.
| Medical condition/information type | Description |
|---|---|
| Blood vessel diseases | If you have a blood vessel disease anywhere in the body, such as the brain, chest, arms, or legs. |
| Heart disease and blood pressure | High blood pressure, heart disease, irregular heartbeat, or a previous heart attack. |
| Brain-related history | If you have had a previous stroke, a history of bleeding in the brain, or a severe head injury. |
| Mental health | Mental illnesses such as schizophrenia, dementia (memory loss), or if you or someone in your family has had suicidal thoughts or plans. |
| Other health conditions | Liver disease, a history of drug or alcohol addiction (Substance use disorder). |
| Allergies | If you have an allergy to Esketamine, Ketamine, or any other medicine, food, or dye. |
| Pregnancy and breastfeeding | If you are pregnant, trying to get pregnant, or breastfeeding. |
How do you use this medicine?
This is the most important thing you need to know. This is not a medicine that you can take home and use.
This medicine should only be used in a hospital or clinic, under the direct supervision of a doctor or trained healthcare professional.
- You spray it yourself: Your doctor or nurse will clearly show you how to use this nasal spray device, how much to use, and when to use it. You will spray it into your nose yourself under their supervision.
- Observe for several hours: After taking the medicine, you will be observed for at least two hours.The medical team will monitor you. They will check things like your blood pressure and heart rate and decide if you are fit to go home.
- Driving is prohibited: This is very important. You cannot drive a vehicle for any reason on the day of taking the medicine. You also cannot do anything that requires full mental attention. It is imperative that a family member or friend comes to take you home. You will be able to drive normally again the next day after you have had a good night's sleep.
- Be careful about food and drink: This medicine can cause nausea and vomiting. Therefore, you should stop eating at least 2 hours before taking the treatment. You should also stop drinking fluids, such as water, at least 30 minutes before .
- Other nasal sprays: If you are using other nasal corticosteroids or nasal decongestants, you should use them at least one hour before taking this Esketamine treatment.
What to do if you take too much medicine?
This is given in a hospital setting, so the chances of this happening are very low. However, if you feel that you have overdosed on the medicine in any way, inform the medical team immediately. If someone else at home has taken this medicine and this happens, take them to the nearest Emergency Treatment Unit (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
Other things that may interact with this medicine (Interactions)
You should tell your doctor about all the medications you are taking, including vitamins and traditional medicines, because some things can react with Esketamine and cause dangerous conditions.
| Types of things that can collide | Examples |
|---|---|
| Alcohol | Avoid using any type of alcohol. |
| Medications for sleep and anxiety | Benzodiazepines, such as Alprazolam, Diazepam, Lorazepam, are sleeping pills. |
| Other antidepressants | Medications like Amitriptyline, Trazodone, especially MAOI medications like Marplan, Nardil, Parnate. |
| Painkillers and cough medicine | Painkillers from the opioid group. |
| Other | Ketamine, epilepsy medication (e.g. Phenobarbital), muscle relaxants, stimulants for ADHD. |
Things to be careful about when taking medicine
- Regular monitoring: Your doctor will regularly check to see if your condition is improving or worsening. Tell them if there is a change in your symptoms.
- Drowsiness and dizziness: You may feel very sleepy, dizzy, or faint for a few hours after taking the medicine. That is why you are kept under observation in the hospital. This is why you are advised not to drive or operate machinery.
- Risk of addiction: There is a risk of abuse and dependence with this medication. Therefore, your doctor will monitor you for that as well.
- Pregnancy: You should not take this medicine if you are pregnant. This medicine can cause serious birth defects in the baby.
- Breastfeeding: Do not breastfeed your baby while taking this medicine.
Side effects that may occur due to medication
Like any medication, this one can have side effects. Some are serious, some are common. The most important thing is to let your medical team know immediately if you notice anything unusual.
| Classification of side effects | |
|---|---|
| 🚨 Serious side effects should be reported to the doctor or nurse immediately. | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Central nervous system depression (CNS depression) | Slow or shallow breathing, difficulty breathing, excessive sleepiness, feeling faint, confusion. |
| Feeling of separation (Dissociation) | Feeling detached from one's thoughts, feelings, and surroundings, as if in a dream. |
| Increased blood pressure | A sudden, significant increase in blood pressure. |
| Deterioration of mental state | Suicidal thoughts, increased depression. |
| 🙂 Usually there is nothing to worry about, but if the side effects persist, you should tell your doctor. | |
| Anxiety, restlessness | Dizziness and drowsiness |
| Nausea and vomiting | Feeling of unusual happiness, excitement |
| Numbness, decreased sense of touch | |
Take-Home Message
- Esketamine is a special treatment that is given only in a hospital under medical supervision for severe depression that has not been treated with other medications.
- You should not drive or do anything that requires attention on the day you take this medicine. You must have someone to take you home.
- Tell your doctor about all your medical conditions and all the medications you take without hiding anything .
- You will be monitored by a medical team for several hours after taking the medicine, as serious side effects can occur.
- This medicine is not suitable for pregnant or breastfeeding women. It is also not approved for children.
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