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FDA approves nasal spray for hard-to-treat depression

Close-up of a nasal spray bottle spraying liquid.

April 9, 2019—The U.S. Food and Drug Administration (FDA) has approved a rapid-acting drug that shows promise in lifting depression when other antidepressants haven't helped. Some effects of the drug, esketamine, may be seen within two days. In contrast, standard antidepressants take weeks to kick in.

Esketamine (sold as Spravato) is a nasal spray. It's for people who've tried at least two other antidepressants without success. And it should be taken along with an oral antidepressant.

This newly approved drug is a chemical cousin of ketamine, an anesthetic sometimes used illegally as a street drug. This is the first FDA approval for any use of esketamine.

Esketamine's varied side effects include:

  • Sedation.
  • Dissociation (difficulty with attention, thinking and judgment).
  • A feeling of drunkenness.
  • Dizziness.
  • Nausea and vomiting.
  • Raised blood pressure.

Esketamine also has the potential for misuse and abuse.

Because of these risks, esketamine can only be given under medical supervision in a certified doctor's office or clinic—you can't take it home. Anyone using it must also be monitored for at least two hours after a dose.

Can you separate fact from fiction when it comes to depression? Test your knowledge with this quick quiz.

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