As a treatment for treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal ideation, esketamine nasal spray has been approved by the Food and Drug Administration (FDA). Structurally similar to ketamine, it belongs to the NMDA receptor antagonist class of drugs.
Before administering esketamine nasal spray:
In order to determine whether a patient is suitable for esketamine treatment, a comprehensive medical examination is carried out. This includes a review of the patient's medical history, a physical examination, and an assessment of their mental health.
As part of their discussion with their healthcare provider, patients discuss the risks, benefits, and alternatives of esketamine treatment. They may also discuss any medications they are taking, medical conditions, and possible drug interactions they may have.
Patients are educated about the proper use of esketamine nasal spray, including dosage, administration technique, and potential side effects.
The procedure for administering esketamine nasal spray typically involves the following steps:
A comfortable position is chosen for the patient, and the healthcare provider ensures that the nasal passages are clear before beginning the procedure.
Inhaling slowly and steadily while pressing the pump mechanism of the nasal spray bottle, the patient administers the prescribed dose by holding the bottle upright.
The patient repeats the administration process in the other nostril if the prescribed dose consists of more than one spray.
After administration, the patient remains under observation for at least two hours to monitor for any immediate adverse reactions.
After receiving esketamine nasal spray:
Patients are monitored closely during and after administration for adverse reactions or side effects. Vital signs may be monitored, and patients may be observed in a healthcare setting before leaving.
Due to the possibility of cognitive and motor impairments, patients are advised not to drive or operate heavy machinery on the day of treatment.
Patients can usually resume normal activities after the observation period, but they may experience lingering effects, such as dizziness or dissociation.
Esketamine nasal spray can be effective for treating TRD and MDD with suicidal ideation, but it is not without risks. Some of the most common side effects include:
Dizziness
Dissociation
Nausea
Increased Blood Pressure
Sedation
Rare but serious side effects may include:
Hallucinations, delusions, or paranoia are examples of psychiatric symptoms
A urinary tract infection can cause symptoms such as pain or difficulty urinating
After receiving esketamine nasal spray treatment, patients should:
Monitor any long-term side effects and complications with their healthcare provider at scheduled follow-up appointments.
As esketamine nasal spray is typically used in conjunction with other treatments, patients should take any prescribed antidepressant medications as directed by their healthcare provider.
Report any changes in mood, behavior, or side effects promptly to their healthcare provider.
By providing rapid relief from symptoms, esketamine nasal spray can offer hope for individuals with TRD and MDD with suicidal ideation. It is easier for patients to optimize their recovery journey if they know about the procedure, risks, and aftercare instructions.
