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Ketamine is an old medication with a novel anti-depressant effect that was proven in numerous clinical studies during the last decade.  Ketamine has a rapid-acting antidepressant effect, specifically in people with suicidal ideations in both unipolar and bipolar depression. Ketamine works differently than traditional antidepressants: it modulates NMDA and AMPA receptors and acts on the Glutamate pathway in the brain. The mechanism involves activation of BDNF (brain protective neurotrophic factor) and m-TOR (pathway potentiating neuroplasticity).

Ketamine as an antidepressant: overview of its mechanisms of action and potential predictive biomarkers

Ketamine as a novel treatment for major depressive disorder and bipolar depression: a systematic review and quantitative meta-analysis

This could explain significant improvement in cognitive functioning (memory, attention, planning) in addition to resolving suicidal ideations observed in people after Ketamine administration. In 2019, the endonasal form of Ketamine (s-ketamine) was approved by FDA for people with advanced depression complicated by suicidality.


Currently, it is reimbursed by most the insurance including Medicaid and Medicare. S-ketamine nasal spray is self-administered by a patient under supervision of a healthcare provider in the psychiatric office. It has to be taken with current psychiatric medications including antidepressants. Healthcare providers monitor patient for 2 hours in an office after administering s-ketamine. Mild elevation of blood pressure and mild sleepiness and detachment are expectable after administration of medications since these changes in blood pressure and arousal level allow the medication to work on the brain.


Treatment Resistant Depressive, Mood and  Posttraumatic Stress Disorders

In a long-term clinical trial patients who continued endonasal S-ketamine were less likely to experience a return of depressive symptoms

If side effects occur, they are usually mild and happen right after taking Spravato; most of the time,  they go away the next day

Endonasal s-ketamine is only available through REMS and could be administered only in healthcare settings.

Visit Spravato.com  to learn more.