Ketamine Nasal Spray: A Comprehensive Guide
Ketamine nasal spray has gained attention in recent years for its rapid and effective treatment of various mental health conditions, particularly depression. Initially used as an anesthetic, ketamine has emerged as a promising alternative to traditional antidepressants for individuals who have not responded to other treatments. This article provides an in-depth look into ketamine nasal spray, its benefits, uses, and availability. Additionally, we will discuss how and where to buy ketamine nasal spray in the USA, buy ketamine nasal spray in Europe, buy ketamine nasal spray in Australia, and buy ketamine nasal spray in the UK.
What is Ketamine Nasal Spray?
Ketamine is a medication originally developed as an anesthetic for surgery. Over time, ketamine’s effects on mood and cognition made it a potential treatment for mental health disorders. Ketamine nasal spray, or Spravato, provides faster absorption and quicker action than oral tablets or infusions.
Spravato was approved by the U.S. The FDA approved ketamine nasal spray in 2019 for adults with major depressive disorder (MDD) resistant to other antidepressants. Its unique mechanism sets it apart from traditional antidepressants like SSRIs, offering hope for chronic depression.
A New Ketamine Nasal Spray Has Been Approved for Depression (But It’s Not for Everyone)
More than one in 10 Americans takes an antidepressant to help subdue the debilitating symptoms of clinical depression.
But for many of them, that medication doesn’t work. The feelings of sadness, lack of enjoyment, hopelessness, loss of energy, and changes in sleep and appetite can’t be shaken.
A new medication coming to the market may help these people with so-called treatment-resistant depression. It’s a nasal spray called esketamine (Spravato) that was recently approved by the FDA.
“For people who are not getting enough help from currently available antidepressants, this could be something that could be added to that and possibly get a better response, in the short-term,” says psychiatrist Amit Anand, MD, who is also Vice-Chair for Research at the Center for Behavioral Health and Director of the Mood Disorders Program.
How Does Ketamine Nasal Spray Work?
Ketamine nasal spray works by targeting the NMDA receptors in the brain, which are involved in glutamate signaling. Glutamate is a neurotransmitter that plays a crucial role in mood regulation and cognitive function. When ket interacts with NMDA receptors, it leads to the release of other chemicals that help promote neural plasticity, enhance mood, and improve the brain’s ability to process emotions and thoughts.
Unlike traditional antidepressants, which typically take several weeks to show effects, ket nasal spray can produce rapid improvements in mood, often within hours of administration. This makes it particularly beneficial for individuals with severe depression or those in crisis who need quick relief.
Mechanism of Action
Ket affects glutamate transmission, stimulating brain-derived neurotrophic factor (BDNF) production. BDNF encourages the growth of new neurons. This process, called neuroplasticity, helps reset the brain and restore balance to mood and cognition. As a result, patients who are resistant to traditional antidepressants may find ketamine nasal spray to be an effective solution.
Indications for Use of Ketamine Nasal Spray
Ket nasal spray is primarily used to treat major depressive disorder (MDD), especially in cases where other treatments have failed. It can be prescribed in conjunction with an oral antidepressant as part of a comprehensive treatment plan. The FDA-approved indications for ketamine nasal spray include:
- Treatment-resistant depression (TRD): Patients who have not found relief with at least two other antidepressant medications.
- Depressive episodes associated with bipolar disorder: Ketamine may also be prescribed to help manage mood symptoms in individuals with bipolar disorder who experience depressive episodes.
- Suicidal ideation: Ketamine nasal spray has shown promise in reducing suicidal thoughts in people with severe depression, providing immediate relief to those in crisis.
Benefits of Ketamine Nasal Spray
Rapid Onset of Action
One of the key advantages of ketamine nasal spray is its rapid onset of action. Unlike traditional antidepressants, which can take weeks to show effects, ketamine nasal spray can produce noticeable improvements within hours. This makes it an appealing option for patients who are in acute distress or experiencing suicidal ideation.
Alternative to Traditional Antidepressants
Ket offers a viable treatment option for individuals who have not responded to conventional antidepressants. Many patients who struggle with chronic depression or bipolar disorder may have tried multiple medications without experiencing any lasting relief. Ketamine nasal spray can provide a new avenue for these individuals to find relief from their symptoms.
Potential for Long-Term Relief
While ket nasal spray can provide rapid relief, research suggests that it may also offer long-term benefits. Some studies indicate that ketamine can help to “retrain” the brain, creating lasting changes in neural pathways. These changes may result in longer-term symptom improvement, potentially reducing the need for continuous treatment.
Low Risk of Abuse
Unlike other forms of ket (such as the intravenous form or recreational use), the nasal spray formulation is designed to be used under the supervision of a healthcare provider. The controlled environment in which it is administered minimizes the risk of misuse, ensuring that patients receive the treatment they need without compromising safety.
What is esketamine?
The drug is a form of ketamine, a generic drug that’s been used as a form of anesthesia for many years, Dr. Anand says.
Ketamine has also been used for years in smaller doses in IV form for patients with treatment-resistant depression. But as a generic drug, it has not been put through FDA’s review process for that use.
It’s actually a controlled substance (it is sometimes abused as a recreational drug — you may have heard it called Special K). Because of that, and because it can create feelings of dissociation and hallucination in people who take it, the new esketamine nasal spray will only be administered in a doctor’s office or hospital setting.
“It’s a slightly different form of ketamine and will be given as nasal puffs, but the effects are essentially the same,” Dr. Anand says.
A patient will go to their doctor once or twice a week to get nasal puffs of a dose of esketamine. Because they may experience disorientation or confusion immediately afterward, they will stay at the doctor’s office for two hours. They are also advised not to drive, operate machinery or undertake a task which requires similar mental effort for the rest of the day.
How is Ketamine Nasal Spray Administered?
Ketamine nasal spray is administered through the nose, typically with a metered-dose spray. A healthcare professional will supervise the administration during the initial treatments to ensure proper use and to monitor any potential side effects.
The typical treatment protocol involves:
- Initial Dosage: Patients usually start with a dose of 56 mg of ketamine (1 spray) administered twice a week for the first few weeks. This may be adjusted depending on the patient’s response to the treatment.
- Maintenance Dosage: After the initial phase, the frequency of treatments may be reduced to once a week or biweekly.
- Monitoring: Ketamine nasal spray is usually given in a healthcare setting, where patients can be monitored for side effects. After administration, patients are often observed for 2 hours to ensure that there are no adverse reactions.
Why it’s promising
One potential benefit of the new drug is that it’s fast-acting. People may notice a relief in symptoms within just a few hours, and it could last for several days, Dr. Anand says. Most oral antidepressants, on the other hand, can take weeks to start working.
That’s because it works in a different way from other depression drugs. “Whereas most other available antidepressants work mainly on the serotonin, norepinephrine or dopamine systems, ketamine has major effects on glutamate, which is a different neurotransmitter that is much more prevalent in the brain,” Dr. Anand says.
Side Effects of Ketamine Nasal Spray
While ketamine nasal spray is generally well-tolerated, some individuals may experience side effects. Common side effects include:
- Dizziness or lightheadedness
- Drowsiness or sedation
- Increased blood pressure
- Nausea or vomiting
- Dissociation or feeling “detached” from reality
These effects are typically short-lived and resolve within a few hours after administration. However, patients should always discuss potential side effects with their healthcare provider before starting treatment.
Who Should Avoid Ket Nasal Spray?
Ketamine nasal spray is not suitable for everyone. Individuals with certain medical conditions should avoid its use, including:
- History of substance abuse: While the nasal spray form has a lower risk of misuse, individuals with a history of addiction may be at greater risk of developing a dependency on the medication.
- Severe hypertension or heart disease: Ketamine can cause an increase in blood pressure and heart rate, making it unsuitable for individuals with uncontrolled high blood pressure or cardiovascular disease.
- Psychosis or severe mental illness: Ketamine may exacerbate symptoms of psychosis or other severe mental health conditions.
It is crucial for patients to discuss their medical history with their healthcare provider before starting ketamine nasal spray to ensure its safety and effectiveness.
Availability of Ketamine Nasal Spray
Ketamine nasal spray is available in both the USA and Europe, but its accessibility can vary depending on the region. In the USA, the drug is FDA-approved for use in patients with treatment-resistant depression, and it is typically available through certified healthcare providers and specialized clinics. In Europe, the availability of ketamine nasal spray may differ by country, and patients may need to consult with their healthcare providers to determine if it is an option for them.
Buy Ketamine Nasal Spray in the USA
In the USA, patients can buy ketamine nasal spray through licensed healthcare providers. Since it is a controlled substance, it is not available over-the-counter, and a prescription is required. Patients must undergo an evaluation to determine if ketamine nasal spray is the right treatment for their condition. It is typically administered in a clinical setting, although some patients may have the option to take it at home under supervision.
Buy Ketamine Nasal Spray in Europe
However, In Europe, the availability of ketamine nasal spray varies by country. In some countries, such as the UK, ketamine nasal spray may only be available through private clinics or specialized healthcare centers. In other European countries, it may be accessible through the public healthcare system with a prescription from a qualified healthcare provider. Patients interested in buying ketamine nasal spray in Europe should consult with their doctor to explore their options.
Buy Ketamine Nasal Spray in Australia
In Australia, ketamine nasal spray is also becoming more widely available for treatment-resistant depression. The approval and accessibility may differ by region, but patients seeking to buy ketamine nasal spray in Australia can do so through licensed medical centers, clinics, and under the supervision of a healthcare professional. As with other regions, a prescription is required, and the treatment is often administered in a controlled clinical environment.
Buy Ketamine Nasal Spray in the UK
The UK is another region where ketamine nasal spray has seen growing use in treating mental health conditions such as treatment-resistant depression. However, patients in the UK may need to buy ketamine nasal spray in the UK through private clinics, as its availability through the National Health Service (NHS) may be limited. A prescription from a licensed healthcare provider is required, and the treatment will typically be administered in a specialized setting.
An imperfect solution
Beyond potential side effects, ketamine does have additional drawbacks. Though it has been used safely as a short-term anesthetic and in lower doses as a short-term antidepressant, doctors don’t yet understand whether it’s safe and effective to use over many months or years.
“This drug affects a major neurochemical in the brain, and if you interfere with that long-term, we’re not sure what the effects of that are going to be,” Dr. Anand says. “It’s also a drug of addiction, and people can misuse it or overuse it.”
There’s also no guarantee that it will work in all groups of people with treatment-resistant depression. And, like other antidepressants, there’s always the chance that it could make symptoms worse.
Esketamine was studied in five clinical trials leading up to its approval. Only one short-term trial, and its follow-up, longer-term relapse prevention trial of patients who had benefited from ketamine, produced positive results that were statistically significant, Dr. Anand says. Another study focused solely on adults over age 65 and found that benefit of treatment with antidepressants plus ketamine in that group of patients did not reach statistical significance.
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For patients most in need
Currently, for patients who are very depressed, potentially suicidal and not responding to currently available antidepressants. The next step is to offer electroconvulsive therapy (ECT) or transcranial magnetic stimulation (rTMS), Dr. Anand says. These treatments use electric currents and magnets, respectively, to stimulate nerve cells in the brain.
ECT is a time-tested. Effective treatment which can make people come off the depression in matter of days or a few weeks. But it comes with its own set of undesirable side effects.
“You have to be put under general anesthesia for ECT, and some people complain of memory problems afterward,” he explains. “It also has a social stigma attached to it.”
Dr. Anand is hopeful that esketamine can become an easier alternative to these treatments when a quick response is require. He’s currently the lead investigator on a large multi-site clinical trial that’s testing out whether ketamine infusions are as effective as ECT therapy for these patients.
“Until now, we had nothing but ECT for patients not responding to other medicines,” he says. “Ketamine offers another option for quick recovery without anesthesia or memory issues.”
Conclusion
Ketamine nasal spray has emerged as a revolutionary treatment option for patients with treatment-resistant depression and other mental health conditions. Its rapid onset, effectiveness, and potential for long-term relief make it a valuable addition to the mental health treatment landscape. While it is not suitable for everyone, it offers hope to individuals who have not found relief with traditional antidepressants.
For those looking to buy ketamine nasal spray in the USA, buy ketamine nasal spray in Europe, buy ketamine nasal spray in Australia, or buy ketamine nasal spray in the UK, it is important to work closely with a healthcare provider to ensure that the treatment is appropriate and safe. By doing so, patients can access this cutting-edge therapy and potentially improve their mental health and overall quality of life.
For more information on ket nasal spray. Visit the official FDA page on Spravato or check out Mental Health America for more resources on mental health treatment options.
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