Sometimes it is very difficult to fight a condition called depression. When there is no change in your condition even after taking medication and doing everything the doctor says, the frustration and loneliness that comes to mind cannot be expressed in words. If you are also someone who is suffering from a similar experience, this article will be very important for you. Today we are talking about a special treatment that is used in cases where the commonly prescribed antidepressants have not provided relief, that is, the Esketamine Nasal Spray.
Simply put, what is Esketamine?
Esketamine (also known by the brand name Spravato) is a medication used to treat depression. But it's not a one-size-fits-all treatment. Your doctor will only consider this treatment if you have depression and you've tried at least two other antidepressants and they haven't helped you as much as you'd like. That means it's a specific treatment for people who haven't responded to other treatments .
Things you need to tell your doctor before taking this medicine
Before starting this treatment, it is extremely important to give your doctor a complete description of your health condition. If you have any of the conditions below, be sure to tell them about it.
| Condition | Description |
|---|---|
| Heart and blood pressure | Having a history of high blood pressure, heart disease, heart attack, or irregular heartbeat. |
| Brain and blood vessels | Having a brain hemorrhage, stroke, head injury, or blood vessel disease in the brain, chest, limbs, or elsewhere. |
| Mental health | Other mental illnesses such as schizophrenia, dementia, suicidal thoughts or attempts (in yourself or someone in your family). |
| Other situations | Liver disease, a history of drug or alcohol addiction, allergic reactions to Esketamine, Ketamine or other medications, foods, or dyes. |
| Pregnancy | If you are currently pregnant, trying to get pregnant, or breastfeeding, be sure to let us know. |
How do you use this medicine? This is very special!
The most important thing you need to understand here is that this is not a medicine that you can take home . This medicine is only used under medical supervision, in a hospital or clinic.
- Under medical supervision: You should use this nasal spray under the supervision of a doctor or trained medical staff. They will clearly teach you how to use it and how much to use.
- Two-hour observation period: After taking the medicine, you will be observed by medical staff for at least two hours . They will check your blood pressure and other conditions and decide if you are well enough to go home.
- Driving is strictly prohibited: This is very important. You cannot drive for any reason on the day of taking the medicine. Not only that, but you should not operate machinery or do anything that requires concentration. Therefore, it is imperative that you bring a family member or friend to take you home. After a good night's sleep, you will be able to return to normal activities the next day.
- Be careful with food and drink: This medicine may cause nausea and vomiting. To avoid this, do not eat anything 2 hours before taking the medicine. Also, stop drinking liquids, including water , 30 minutes before taking the medicine.
- Other nasal sprays: If you are using other nasal steroids (corticosteroids) or decongestants, use them at least one hour before Esketamine spray.
If you miss a dose, meaning you are unable to attend your scheduled appointment, please notify your doctor immediately. It is very important to continue this treatment as prescribed.
What to do if you take too much medicine?
This is given under medical supervision so the chances of this happening are low. However, if something like this happens, immediately call the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Treatment Unit (ETU) of the nearest hospital.
Other things that may interact with this medicine
It is very important to tell your doctor about all medications, vitamins, nutritional supplements, and herbal products you are taking. Some things can interact with this medicine. Be especially careful about these things:
- Alcohol
- Medications that calm the mind and induce sleep
- Some medicines for colds, coughs, and allergies (Antihistamines)
- Other antidepressants (e.g. Amitriptyline, Fluoxetine, Sertraline)
- Some medications for epilepsy (e.g. Phenobarbital)
- General anesthetics
- Muscle relaxants used during surgery
- Narcotic medications for severe pain
- Antidepressants of the type called MAOIs
- Psychostimulants (e.g. Amphetamines, Methylphenidate)
This list is not complete, so tell your doctor about everything you take.
What are the possible side effects?
Like any medication, this one can have side effects. Some are serious, some are common. It's important to be aware of these.
| Side effects that should be reported to your medical team immediately | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Dissociation | Feeling detached from one's thoughts, feelings, body, and surroundings, as if floating. A feeling of detachment from reality. |
| Increased blood pressure | Significant increase in blood pressure after taking the medicine. |
| Change in mental status | Suicidal thoughts, worsening of depression, agitation. |
| Things to tell your doctor if they persist or are bothersome | |
| Things that are often felt | Dizziness, drowsiness, nausea, vomiting, anxiety. |
| Other effects | Difficulty concentrating, problems with memory or speech, numbness in the body, feeling of extreme happiness. |
Take-Home Message
- Esketamine is a special treatment for severe depression that has not responded to other medications, and is only given under medical supervision.
- This is not a medicine you can take home and use. It is always given in a hospital or clinic.
- On the day of taking the medicine, it is essential that someone takes you home. Avoid driving or doing anything that requires concentration until you have had a good night's sleep.
- Give your doctor a complete description of all other medications you are taking, existing illnesses, and allergies.
- Be aware of serious side effects (especially mental changes, high blood pressure, allergies) and notify the medical team immediately if you notice any such symptoms.
- Always follow your doctor's instructions. Do not stop treatment halfway.
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