Esketamine is the first rapid-acting antidepressant, and can work within hours. It’s also the first medication in 30 years that treats depression through a new mechanism.
That mechanism may explain why esketamine is making such a big difference for people with depression, and why it can work when other antidepressants have not.
Esketamine calms the part of the brain that reels with ruminative worry. It’s called the default mode network, because that’s the mode that the brain defaults to when it has nothing else to do: Dwelling, worrying, over-analyzing, obsessing, brooding. Psychologists call this rumination.
New possibilities open up when the mind is freed from rumination. Anxiety is replaced with peace, and self-criticism with self-transcendence. People feel a greater sense of meaning and connection, exactly the opposite of what depression does.
Unlike other medications, esketamine has to be taken at a certified medical office. Part of the reason is that esketamine can be abused in large doses, and giving in the office prevents abuse and diversion. The other reason is safety. Esketamine can cause drowsiness and an out-of-body-like state called dissociation. Those feelings are temporary and go away within a few hours. Blood pressure elevations are possible, so that needs to be monitored.
The Mood Treatment Center is the first clinic in the Triad to offer esketamine. We have a dedicated team to help people navigate their insurance and get coverage for the treatment if possible. Contact our team here.
Esketamine is nearly the same as ketamine, a medicine that’s been making news as a breakthrough for depression for 20 years. Ketamine is a mixture of two molecules that are mirror images of each other: Esketamine and Arketamine. By isolating the Esketamine molecule, Janseen pharmaceuticals were able to study it and patent it for depression. They also found a way to deliver it as a nasal spray, a big advantage over ketamine which is only available intravenously.
Esketamine is also known by it’s brand name: Spravato.