You’ve probably heard of Special K, but have you heard that this “club drug” has a special use? A version of it is now being used to officially — and legally — treat depression.
Esketamine (also called Spravato) is a derivative of the anesthetic party drug ketamine. The media is calling it one of biggest breakthroughs for the treatment of depression since Prozac came along. Its effects can be felt within hours, unlike traditional antidepressants which can take several weeks to work, and it can potentially help patients with medication-resistant depression.
Perhaps it can be thought of as the responsible clean-cut cousin of ketamine.
What the studies say about esketamine
According to the FDA summary of evidence, the results of esketamine were quite compelling and are worth checking out. Don’t have time? Here’s the quick tea on esketamine:
- The drug, in addition to taking a daily antidepressant pill, can significantly benefit those suffering from treatment-resistant depression when compared to those taking a daily antidepressant pill bit itself.
- Esketamine has helped a significant number of people feel better quicker and it prevented them from relapsing back into depression.
- The FDA was so astonished by the results that it approved the medication at an accelerated pace with its “Breakthrough Therapy” and “Fast Track” designations. Both of these designations are fancy ways of saying esketamine is considered by the FDA to be so advantageous that it should be available to people with treatment-resistant depression as soon as possible because it may be better than any other treatment option available.
All of this is extremely promising, but because this drug was pushed through the FDA on a fast track there is still a lot to be learned about it. There is no data, for instance, about the effects of taking esketamine over a long period of time. We do know that when ketamine is taken at high doses for a long period of time it can damage the urinary system, but there isn’t evidence yet relating to esketamine. We also do not know how Spravato compares to other interventional treatments for severe depression such as Transcranial Magnetic Stimulation or Electroconvulsive Therapy. Talking with a psychiatrist familiar with all of these modalities can help sort out what treatment option(s) is the best choice for each individual.
The results of esketamine at Brooklyn Minds
Mental health practices, like Brooklyn Minds, are monitoring patients and collecting data in real-time. Though we’ve only gathered short-term data since it was approved in Spring of 2019, we’ve seen results similar to those described in the clinical trials. The patients being treated with Spravato have reported that the drug is making them feel better beyond what their traditional antidepressants alone are able to do.
One of our Brooklyn Minds patients put the overall experience this way:
“I would describe the actual experience of taking it as relaxing. It’s easy to take. You just spray it up your nose, but it can taste weird. Overall, it’s effects have been really helpful. Last year during the holidays I was actively suicidal and supposed to be in the hospital and this year I was fine. I’m not going to lie, I still get suicidal thoughts but they pass through my head quickly now. Also, I no longer just want to sit at home. I am able to get up and do stuff… I’m still on antidepressants and in therapy so it’s in combination, but Spravato [has really made] the difference. I can do more stuff now and there’s no denying that fact. That is why I keep coming back here to take it.”
It does not work for everyone but when it does, the results do not appear to be subtle. Anything that can cause such a dramatic change is bound to have potential side effects and Spravato is no exception. Let’s take a look at what to expect:
The process of taking esketamine for depression
You cannot get this drug and take it at home with your friends. The drug monitoring is taken very seriously. When prescribed, the patient self-administers the nasal spray under the supervision of a health care provider in a certified doctor’s office, and the patient is monitored for side effects for two hours. In our experience, the side effects are mild. The most common side effects seen while administering the drug at Brooklyn Minds have been the following:
- A slight rise in blood pressure
- Mild dissociation (colors being brighter, sounds being louder, feeling like you are in a movie and watching what is happening)
- Tiredness
- Nausea
- Dizziness
- The feeling of being mildly intoxicated
Some patients listen to jazz music, some continue to work on a laptop, and some use the time to nap or listen to guided meditations. People tend to find the experience soothing. When used at appropriate dosages and under medical supervision, it is not like the K-hole experience you hear people talking about, which is used recreationally and potentially mixed with other chemicals.
Bet you didn’t realize the street drug ketamine had a tried-and-true FDA-approved cousin, esketamine, but now you do.
Why Brooklyn Minds offers esketamine
We do not recommend buying Ketamine off the street to help with your depression. We do recommend continuing to follow the research and having a conversation with a certified Spravato provider to see if taking esketamine under medical supervision is a good treatment option for you.
This new drug really is improving lives in a way other antidepressants are often failing to do and it is changing those lives very quickly. But know that Spravato is not a stand-alone quick-fix cure.
At Brooklyn Minds, Spravato treatment is just a part of a full range of integrated services. We are delighted to offer this cutting edge treatment, but we will continue to thoroughly study it to ensure that it is healthy, safe, and effective.
Of note, prior to the FDA approval of Spravato, patients turned to IV ketamine infusions which are not FDA approved for depression and therefore are not covered by insurance. There has been criticism about how much the makers of Spravato, Janssen Pharmaceuticals are charging for the drug but one main reason we wanted to offer it was because insurance companies are starting to cover it for those who qualify clinically. Practically speaking, this means patients who could not afford IV infusions now have access to this class of medication using their insurance benefits.
As a therapeutic treatment option, esketamine perfectly aligns with the heart of Brooklyn Minds’ mission of keeping patients out of psychiatric hospitals whenever possible and providing them access to innovative and evidence-based approaches.
