Esketamine Nasal Spray for Depression: Finding the Right Dosage for You

When round after round of antidepressants fail, it’s easy to become disillusioned with medication and lose hope. Ketamine has been suggested as an alternative solution in the past, and it’s now gaining traction among those with treatment-resistant depression. 

At Ketalink Ketamine Center in Levittown, New York, Dr. Hau Nguyen and his team often recommend an esketamine nasal spray known as Spravato® for treatment-resistant depression. Here’s what you need to know about dosing for esketamine nasal spray. 

Ketamine for depression

While ketamine has a reputation as an anesthetic and tranquilizer, that’s far from its only application. 

For years, people struggling with depression and suicidal thoughts have shared positive experiences with ketamine. Some patients given ketamine after a suicide attempt reported significant improvements in their mental health, which stirred hopeful curiosity among researchers. 

In 2019, an esketamine nasal spray called Spravato was approved by the FDA for treatment-resistant depression. Esketamine is derived from ketamine, belonging to the same group of drugs. These are known as N-methyl-D-aspartate (NMDA) receptor blockers, which bind to neurotransmitters in the brain to increase the amount of glutamate. 

This not only reduces depression and improves mood, but repairs neural pathways within the brain. Chronically high levels of the stress hormone cortisol can damage the brain’s communication system, causing you to fall back into depression and anxiety time and time again.

At Ketalink Ketamine Center, we often recommend Spravato for patients with treatment-resistant depression. 

Finding the right Spravato dosage

Esketamine works by increasing levels of glutamate in the brain, which sets it apart from selective serotonin reuptake inhibitors (SSRIs), which aim to increase serotonin and dopamine. Spravato is also delivered differently than oral antidepressants; the spray enters your nasal passages, where it is absorbed directly into the bloodstream. 

This is more comfortable and convenient than ketamine infusions, which require an IV. The spray still makes it to your brain faster than oral medication, allowing it to work more effectively. 

Dosage depends on the severity of your depression and how you respond to the first few doses. The induction (starting) phase lasts about four weeks, during which you might receive two doses per week. 

From there, you should be able to go longer between doses. Gradually, you will go from two doses per week to once a week. Your provider will continue to check in and make sure that you’re responding well.

Struggling with your mental health? Don’t give up on treatment. To learn more about esketamine nasal spray, call Ketalink Ketamine Center at 516-703-4937 or book an appointment online today.