Clinical data | |
---|---|
Trade names | Ketanest, Spravato, Vesierra, others |
Other names | Esketamine hydrochloride; (S)-Ketamine; S(+)-Ketamine; JNJ-54135419 |
AHFS/Drugs.com | Monograph |
MedlinePlus | a619017 |
License data |
|
Dependence liability | Low–moderate (physical); high (psychological)[1] |
Routes of administration | Intranasal[1] |
Drug class | NMDA receptor antagonist[1] |
Legal status | |
Legal status | |
Identifiers | |
| |
Chemical and physical data | |
Formula | C13H16ClNO |
Molar mass | 237.73 g·mol−1 |
3D model (JSmol) | |
| |
| |
(verify) |
Esketamine, sold under the brand name Spravato among others, is a medication used for treatment-resistant depression or depression with acute thoughts of suicide.[1][4] It; however, appears to be less effective than ketamine.[6] It may also be used for anesthesia and pain.[7] It is used as a nasal spray or by intravenous injection.[1][7] In depression benefits generally occur within 24 hours.[1]
Common side effects include dissociation, dizziness, sedation, headache, anxiety, vomiting, and increased blood pressure.[1] Other side effects may include misuse.[4] The compound is the S(+) enantiomer of ketamine.[8] Use when breastfeeding is not recommended.[9] It primarily acts by blocking N-methyl-D-aspartate (NMDA) receptors.[1]
Esketamine came into medical use in Germany in 1997.[10][11] It was approved for medical use in the United States and Europe in 2019.[8][12] It is available as a generic medication.[13] In the United States the nasal spray costs about 5,500 to 7,900 USD for the first month of treatment as of 2021.[14][4] The intravenous formulation in the United Kingdom costs the NHS about £26 for 10 vials of 50 mg each.[7]
References
edit- ^ a b c d e f g h "Esketamine Monograph for Professionals". Drugs.com. Archived from the original on 23 January 2021. Retrieved 23 July 2021.
- ^ "Spravato 28 mg nasal spray, solution - Summary of Product Characteristics (SmPC)". (emc). Archived from the original on 28 August 2021. Retrieved 24 November 2020.
- ^ "Vesierra 25 mg/ml solution for injection/infusion - Summary of Product Characteristics (SmPC)". (emc). 21 February 2020. Archived from the original on 21 April 2021. Retrieved 24 November 2020.
- ^ a b c d "Spravato- esketamine hydrochloride solution". DailyMed. 6 August 2020. Archived from the original on 18 March 2021. Retrieved 26 September 2020.
- ^ "Spravato EPAR". European Medicines Agency (EMA). 16 October 2019. Archived from the original on 23 November 2020. Retrieved 24 November 2020.
- ^ Bahji, A; Vazquez, GH; Zarate CA, Jr (15 February 2021). "Erratum to "Comparative efficacy of racemic ketamine and esketamine for depression: a systematic review and meta-analysis" [Journal of Affective Disorders 278C (2021) 542-555]". Journal of affective disorders. 281: 1001. doi:10.1016/j.jad.2020.11.103. PMID 33229028.
- ^ a b c BNF (80 ed.). BMJ Group and the Pharmaceutical Press. September 2020 – March 2021. p. 1411. ISBN 978-0-85711-369-6.
{{cite book}}
: CS1 maint: date format (link) - ^ a b Commissioner, Office of the (24 March 2020). "FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor's office or clinic". FDA. Archived from the original on 23 July 2021. Retrieved 23 July 2021.
- ^ "Esketamine". Drugs and Lactation Database (LactMed) [Internet]. 2019. PMID 31038855.
- ^ Roche, Victoria; Zito, William S.; Lemke, Thomas; Williams, David A. (29 July 2019). Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. p. PT1423. ISBN 978-1-4963-8587-1. Archived from the original on 28 August 2021. Retrieved 23 July 2021.
- ^ Himmelseher S, Pfenninger E (December 1998). "[The clinical use of S-(+)-ketamine--a determination of its place]". Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie. 33 (12): 764–70. doi:10.1055/s-2007-994851. PMID 9893910.
- ^ "Spravato". Archived from the original on 23 November 2020. Retrieved 23 July 2021.
- ^ Ferrier, I. Nicol; Waite, Jonathan (4 July 2019). The ECT Handbook. Cambridge University Press. p. 150. ISBN 978-1-911623-16-8. Archived from the original on 29 August 2021. Retrieved 23 July 2021.
- ^ "Spravato Prices, Coupons & Patient Assistance Programs". Drugs.com. Archived from the original on 12 November 2020. Retrieved 23 July 2021.