Depression affects millions of people worldwide—impacting over 20 million adults and adolescents in the United States alone.
While many people respond to conventional mental health treatments, research shows that 10-30% of individuals with depression see little to no improvement. However, a ground-breaking new treatment called Spravato™ (esketamine) offers hope for those who haven’t found success with other options.
So, let’s take a closer look at Spravato therapy below. Is this the right option for you? And where can you find this esketamine nasal spray now that it’s been approved by the FDA?
Esketamine for depression: How does it work?
Recently approved by the FDA, Spravato—an esketamine nasal spray—can provide faster and more effective results for treatment-resistant depression. So, what is esketamine exactly?
Ketamine is made up of two mirror-image molecules, R-ketamine and S-ketamine. Esketamine, on the other hand, consists solely of the isolated S-ketamine molecule.
Interestingly, ketamine—the parent compound in esketamine—is an FDA-approved anesthetic that’s been used for nearly five decades in surgeries, veterinary care, and even on battlefields. Its importance was first recognized when the World Health Organization (WHO) added it to its list of essential medicines in 1985.
As the new millennium approached, researchers explored ketamine as a potential antidepressant—and their findings showed great promise.
Scientists found that ketamine treats depression by binding to NMDA receptors in the brain. This triggers the rapid release of glutamate—a key neurotransmitter that activates brain circuits affecting mood and behavior.
Unlike traditional antidepressants, which can take weeks to show effects, ketamine works within hours. This fast-acting relief makes it a powerful option for treatment-resistant depression and is why both ketamine and its derivative, esketamine, have gained significant attention in the mental health field.
In March 2019, the FDA approved Spravato—the esketamine nasal spray—as a treatment for major depression, making it the first FDA-approved NMDA receptor antagonist for treating persistent depression in adults.
While ketamine is administered through IV infusions, esketamine is delivered as a nasal spray. This difference in administration and its targeted action may make esketamine a better fit for some patients, offering a more convenient and accessible treatment option.
Where Can You Find Esketamine?
When the FDA approved Spravato therapy, it gave new hope to adults struggling with persistent and treatment-resistant depression. However, you can’t simply get a prescription for Spravato and pick it up at a local pharmacy. The FDA has strict guidelines for its use and administration.
Ketamine, including esketamine, can provide quick relief for depression. But in large doses or when used incorrectly, it can cause sedation and dissociation. And this is actually why ketamine became popular as a recreational drug in the 1990s.
Because of these risks, however, Spravato is only available through a controlled system called Risk Evaluation and Mitigation Strategy (REMS). So, what does this mean for you?
While esketamine is effective, it must be taken under the supervision of a qualified doctor in an approved medical facility—like our trained Spravato providers at Bespoke Treatment.
Bespoke Treatment is proud to be among the first clinics in Los Angeles and Las Vegas to offer ketamine infusion therapy and Spravato esketamine nasal spray to eligible patients. At Bespoke Treatment, we’re dedicated to providing innovative, proven solutions for all patients. Our Spravato providers are trained to ensure safe administration and personalized care, guiding you every step of the way.
Each Spravato treatment takes about two hours, including close monitoring for your safety. After treatment, you won’t be able to drive until the next day. This means you’ll need to arrange for someone to drive you to and from the clinic for your ketamine or esketamine session.
At the end of the day, there is hope. If you or a loved one is struggling with persistent depression, know you’re not alone. At Bespoke Treatment, we are here to help. Book your appointment with caring and compassionate Spravato providers and discover if esketamine is right for you.
