How Esketamine Nasal Spray Works for Depression Treatment

If you’re struggling with depression, you’re not alone. According to the World Health Organization, more than 264 million people worldwide suffer from depression. While traditional treatments such as medication and therapy have helped many people manage their symptoms, some people with depression may not respond to these options. This is where esketamine comes in. Keep reading to learn more about how esketamine nasal spray works for treating treatment-resistant depression.

The Neurobiology of Depression

While the exact causes of depression are unclear, antidepressants work by impacting the chemicals in the brain, particularly neurotransmitters such as serotonin, norepinephrine, and glutamate. Current traditional antidepressants only target serotonin and norepinephrine, leaving the glutamate system unaddressed. The glutamate system is believed to play a crucial role in depression, which is why it’s an important target for new treatments like esketamine.

What is Esketamine?

Esketamine is a form of ketamine that is administered as a nasal spray. It was approved by the FDA in 2019 for use in patients with treatment-resistant depression (TRD). You may have TRD if you have tried two or more medications for depression with no relief.

Esketamine is a more potent version of the drug ketamine. Because it is considered a controlled substance, medication is administered in a healthcare provider’s office, and patients are monitored for at least two hours after each treatment.

Esketamine treatments come in the form of a nasal spray, which has a brand name called Spravato. The nasal spray is to be used alongside antidepressants to treat more severe cases of depression that are categorized as treatment-resistant depression (TRD).

How Esketamine Nasal Spray Works for Depression

Esketamine works differently from traditional antidepressants by targeting the glutamate system in the brain. By binding to NMDA receptors, esketamine increases the production of brain-derived neurotrophic factor (BDNF), a protein that helps neurons grow and form new connections. The impact on the brain, in turn, leads to an improvement in depressive symptoms with a greater reach and more substantial impact on brain cells with a single dose compared to antidepressants.

Check out the 5 amazing benefits of esketamine nasal spray!

Clinical Trials and Effectiveness

Clinical trials have demonstrated the effectiveness of esketamine in treating depression. Based on our patients’ experience, 69% of people showed improvement in symptoms after just eight treatments. Esketamine has also been found to work quickly, with some patients reporting improvements in symptoms within hours of their first treatment. We have also found that our patients are more likely to recover from depression at their 12-month follow-up with esketamine compared to medication.

Learn more about how esketamine is saving lives.

Safety Considerations

As with any medication, there are potential side effects associated with esketamine. Some common side effects include dissociation, dizziness, nausea, and increased blood pressure. The most common side effects usually only occur within one to two hours after the nasal spray has been administered.

To help ensure the safety of patients, there is a two-hour window of supervision at the clinic following the administration before patients can leave and head home. However, it is important to discuss potential side effects with your healthcare provider before beginning treatment.

Additionally, esketamine is not recommended for individuals with a history of psychosis or substance use disorders.

Integration with Other Treatment Options

Esketamine can be used in combination with other treatments, such as therapy and traditional antidepressant medication. An integrated treatment approach can help improve treatment outcomes for depression. Your healthcare provider can work with you to develop a treatment plan that is tailored to your specific needs.


Depression can be a challenging condition to manage, but there are treatment options available that can help. Esketamine is a new treatment option that targets the glutamate system in the brain and has shown promise in treating treatment-resistant depression.

If you’re struggling with depression and traditional treatments have not been effective for you, esketamine may be a viable treatment option to consider. As with any medication, it is important to discuss potential benefits and risks with your healthcare provider. With the right treatment approach, you can manage your symptoms and improve your overall quality of life.

Interested in getting started with esketamine treatments? Call or text us today at 844-867-8444 and we’d be happy to answer any questions and discuss your options.

Take a free mental health quiz