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FDA-cleared, non-medication depression treatment
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(855) 940-4867
How Can Ketamine-Based Medications Help Treat Depression?
2022-07-14T21:58:40Z
Medically reviewed on by
Regional Medical Director Greater St. Louis
After decades of limited choices in the treatment of depression, ketamine and other medications related to it have taken off as promising new options for those who still suffer. It just might be the treatment for depression that you’ve been waiting for.
Surprisingly, ketamine was originally used as an anesthetic for surgery. Approved in 1970, it was especially useful in some special situations, including emergency surgery in the battlefield. It is sometimes used for anesthesia even today, and it is also commonly used for anesthesia in veterinary medicine. It’s been called a “horse tranquilizer” because, well, it’s been used to tranquilize horses.
Ketamine has also occasionally been a drug of abuse. The FDA categorizes ketamine as a Schedule III drug, which means it has a low or moderate potential for abuse. Ketamine abuse is rare. But still, ketamine as a drug of abuse has acquired some colorful street names such as “special K” and “blind squid.”
The history of ketamine took a surprising turn around 2009 when there were the first reports of a sudden improvement in depression among some people treated with ketamine. People sometimes improved almost immediately with ketamine, and that was in sharp contrast to the several weeks needed for improvement with antidepressants. This rapid improvement with ketamine contradicted what we thought we knew about medicine for depression, and it sounded too good to be true. But, further research into ketamine and ketamine-like drugs proved that the benefit was real. Finally, one of these drugs, esketamine, gained FDA approval in 2019. Esketamine (pronounced like “s-ketamine”) is just one of many treatments recently approved or on the horizon. Psychedelics such as psilocybin, for example, are a possible treatment in the future. New treatments often work when standard treatments such as antidepressants and therapy have failed – so new options give hope to countless people who still suffer from depression.
Esketamine Nasal Spray Treatment at Greenbrook TMS
Esketamine is given as a nasal spray. And, because it’s already FDA-approved, it is usually covered by insurance. We offer that medication at Greenbrook.
Greenbrook TMS is a certified esketamine nasal spray provider. In a typical esketamine nasal spray treatment schedule, you’ll receive two treatments per week for four weeks, and then one treatment per week for the next four weeks. After that, treatment is typically once every one or two weeks.
You’ll receive your treatment in a relaxing area, in a comfy chair in your own private room or cubicle. Throughout your two-hour session, your care team will monitor you, and will be available if you need anything. In addition, the medical provider will be nearby, and will make rounds during your treatment to assess how you are doing.
Are you ready to take the next step in your journey to relieving symptoms of depression? To learn more about your options,
schedule your free consultation with Greenbrook TMS or give us a call at 855-940-4867 today. We offer both esketamine, and
TMS (transcranial magnetic stimulation).
Let's see if we might be a good fit
Take our short quiz to see if TMS therapy or nasal esketamine could be right for you
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You may feel isolated and alone when you have clinical depression, and depression also affects your relationships with family and friends. While the primary focus of your treatment is to improve your mental health, it’s also essential to understand your loved ones may experience their own issues as they try to support you. An understanding of how depression affects relationships can help everyone maintain healthy connections and navigate problems. Here are some of the ways depression may affect the people in your support network.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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