ESKETAMINE NASAL SPRAY FOR DEPRESSIVE PATIENTS

Abstract: 
Ketamine can promptly reduce suicidality and relieve other serious symptoms of depression. Esketamine (Spravato), FDA approved is usually given as a nasal spray. It operates under “S” molecule. Ketamine can be administered intranasally (spray into the nose) for treating resistant mood disorders like depression. An initial clinical trial portrayed that ketamine curtailed the severity of symptoms in PTSD. Investigation of the role of glutamate signalling in other illnesses may provide the impetus to develop novel therapies based on this pathway. Ketamine hits and targets NMDA (N-methyl-D-aspartate) receptors in the brain. By binding with these receptors, ketamine increases the amount of neurotransmitter called glutamate in the spaces between neurons. Administer half of the dose into each nose with the help of mucosal atomizer device or needleless syringe, in the supine position. The total dose is equal to or less than 0.5 mL, which is administered into one nose. Onset of procedural sedation is 5 to 20 minutes. Precautions should be taken while administering ketamine nasal spray in conditions such as hypertension, schizophrenia, alcohol dependence syndrome and raised intraocular pressure.  Ketamine has also been studied and shown beneficial antidepressant effects when administered through oral, IM, SC, sublingual, rectal & intranasal dosage forms. The use of ketamine in depression has been upholder research into the development of novel glutamatergic agents with a longer duration of action. It is anticipated that the outcome of this research will yield faster and more effective agents for initiation, stabilization and maintenance treatment of depression. Research continues to delineate the most effective role for ketamine in depression, and how its use might foster the development of similar agents with a longer duration. Intranasal Ketamine has been used by ketamine clinics for years and have had the same impact as intravenous ketamine, immediate effect with few side effects.