Why is there so much talk about ketamine? It is the first rapid-acting antidepressant, and has proven to be a powerful treatment for depression and suicidality. The problem is, ketamine has only been available as an intravenous (IV) drug, so it’s welcome news that the FDA has cleared a new version, esktamine, that will be delivered through a nasal spray.

Like other treatments for depression, ketamine enhances brain-growth by increasing neuroprotective compounds like BDNF. It differs from other antidepressants, however, in that it works through the neurotransmitter glutamate. We already use medications that work through glutamate, like lamotrigine, amantadine, riluzole, and memantine, but none of these are as effective as ketamine.

Esktamine is not available yet, but if the FDA continues to pass it through the final steps we can expect it may be on the market sometime in 2020.

Read more about treatments that can work when antidepressants have not.


The nose is a direct route to the brain, and esketamine will be released as a nasal spray