Esketamine Treatment

Esketamine (brand name: Spravato®) is a nasal spray approved for the treatment of Treatment-Resistant Depression (TRD) – major depressive disorder that has not responded to at least two different antidepressant medications. It is a regulated medical treatment administered in a clinical setting under medical supervision.
Adults with a confirmed diagnosis of Major Depressive Disorder who have not responded to at least two adequate antidepressant treatments in the current episode. Eligibility is determined by our consultant psychiatrist following a comprehensive assessment.
Esketamine is administered as a nasal spray in our clinic under direct medical supervision. Patients remain at the clinic for a minimum of 2 hours following administration to be monitored for potential side effects including dissociation, dizziness, and blood pressure changes. Patients must not drive on the day of treatment.
The standard treatment schedule is twice weekly for 4 weeks (induction phase), once weekly for 4 weeks (consolidation phase), and then once weekly or once every two weeks (maintenance phase). Individual schedules may vary.
Esketamine is not appropriate for everyone. Contraindications include: history of psychosis or schizophrenia; aneurysmal vascular disease; arteriovenous malformation; history of intracerebral haemorrhage; current substance use disorder. A full psychiatric and medical assessment is required before treatment is initiated.