US FDA approved chemical twin of dissociative psychedelic ketamine to treat depression

Earlier today, the FDA approved esketamine (brand name Spravato), a chemical twin of the dissociative psychedelic/anaesthetic ketamine (Special K), as a treatment for depression. Spravato comes in nasal spray form meant to be administered weekly or every other week depending on the severity of the patient's depression.

'There has been a longstanding need for additional effective treatments for treatment-resistant depression, a serious and life-threatening condition,' said the FDA's acting director of the Division of Psychiatry Products, Dr. Tiffany Farchione, in a press release. 'Because of [safety] concerns, the drug will only be available through a restricted distribution system and it must be administered in a certified medical office where the health care provider can monitor the patient.'

From National Public Radio:

Many doctors who have become comfortable offering ketamine for depression probably won't switch to esketamine, said Dr. Demitri Papolos, director of research for the Juvenile Bipolar Research Foundation and a clinical associate professor at Albert Einstein College of Medicine.

For the past 10 years, Papolos has been prescribing an intranasal form of ketamine for children and adolescents who have a disorder that includes symptoms of depression.

'I'm very pleased that finally the FDA has approved a form of ketamine for treatment-resistant mood disorders,' Papolos said. He said the approval legitimizes the approach he and other doctors have been taking.

But he hopes that doctors who are currently using ketamine continue to do so. 'It'll be a lot less expensive and a lot easier for their patients [than esketamine],' he said.

And animal studies show it's possible that old-fashioned ketamine is a more potent antidepressant than esketamine, Papolos said.

Esketamine 'may not be as effective as a generic that any psychiatrist or physician can prescribe without restrictions,' Papolos said.

Previously on Boing Boing:

• Dissociative psychedelic Ketamine may help suicidal children

• Report: Ketamine aids the chronically depressed

• Ketamine helps depressed patients temporarily experience pleasure again