The Difference Between Ketamine and Esketamine

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The US Food and Drug Administration recently
approved the nasal spray Esketamine for the
treatment of refractory depression and major
depression at imminent risk of suicide.
Esketamine is a drug developed by Johnson
Johnson's Janssen Pharmaceutical Companies under
the name Spravato. It is a glutamate receptor
modulator, which helps restore synaptic
connections in the brain in patients with
chronic depression. Esketamine is getting a lot
of media attention because, like its parent
compound, ketamine, it has a different mechanism
of action for treating depression that is unlike
Prozac and other SSRIs, which was introduced over
30 years ago.
Esketamine vs Ketamine Ketamine, administered
intravenously, has been shown to provide a strong
and rapid antidepressant effect within a few
hours of treatment. Ketamine is an NMDA receptor
antagonist that works through the brain's
glutaminergic system by initiating a cascade of
events leading to synaptogenesis and
neuroplasticity. Allows lost nerve connections
in the brain due to chronic depression to
regenerate. Ketamine is a racemic mixture
consisting of 2 molecular forms, R-
and S-ketamine. Esketamine, which is the S form
of ketamine, is proposed to have the same
antidepressant effects as ketamine.
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Why esketamine if ketamine works? Ketamine is an
old medication that has been used as an
anesthetic for over 40 years. Only recently has
it been shown to be extremely effective in
treating depression and other mood disorders.
However, because it is generic and has limited
profit potential, none of the drug companies will
spend millions of dollars to conduct clinical
trials and promote its psychiatric
indications. Effects of Ketamine and
SPRAVATO Traditional antidepressants are
believed to work by increasing serotonin and
other neurotransmitters. Those neurotransmitters
then affect glutamate, which is also a key
neurotransmitter. Ketamine is believed to be
brought forward to directly affect the glutamate
system. This leads to the activation of receptors
that help build new pathways in the brain.
Ketamine most likely affects the brain in
additional and useful ways. Researchers are
actively studying its effect on
treatment-resistant depression to better
understand the role that ketamine may play. As
with any medication, side effects are possible.
The most common side effects of SPRAVATO REMS
are drowsiness, dizziness, feeling dissociated
and anxiety. With intravenous ketamine for
depression, side effects can include drowsiness,
dissociation, dizziness, and nausea. Both drugs
should only be administered in reputable medical
clinics, where medical providers will observe
patients for two hours after treatment to
monitor for negative side effects. Both
treatments work quickly, but with intravenous
ketamine for depression, it can take three
infusions before the patient notices a change in
mood. Esketamine nasal spray, on the other hand,
often works within hours of treatment. Another
benefit of esketamine is that it can reverse
stress-related changes in the brain.
Additionally, animal studies have indicated that
esketamine is beneficial for the hippocampus,
which is essential for learning and memory. In
the long run, being depressed can shrink the
hippocampus by up to 20, making this a
remarkable finding. It means that esketamine may
help reduce the risk of depression-related
dementia.
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Comparing Spravato to Ketamine That's how
effective Spravato has been in tests. In some
cases, improvement occurred in as little as two
days. When combined with a new oral
antidepressant, seven out of ten people improved
by at least 50, but we know that most of that
improvement came from the new pill, not
Spravato. In our experience with nebulized
ketamine, 80 of patients with
treatment-resistant depression experience great
relief. Patients begin to experience relief in 6
to 72 hours. This is consistent with studies
with IV ketamine.1 With IV ketamine, patients
experience relief in 4 to 72 hours. In one study,
after just two treatments, 90 of patients
improved by at least 50. After six treatments,
an 85 reduction in depression symptoms was
normal. And these results were not complicated by
including other new drugs. These experiments
were conducted in people who had not achieved
sufficient relief with at least two other drug
therapies, and no other new drugs were
introduced. It is better to have direct
comparisons in the same study, but in the absence
of that, we are left with indirect comparisons.
When we compare the results of separate studies,
ketamine is better than Spravato. Ketamine
probably works faster than Spravato. Ketamine
seems to be successful with a higher percentage
of people. It looks like the Spravato visits will
take longer than the Ketamine visits. In the
maintenance phase, Spravato needs up to eight
times as many visits every 60 days. Being a
generic drug, ketamine will cost much less. In
the maintenance phase, ketamine could cost 95
less! In the coming years, head-to-head studies
may shed new light on this question, but
currently, ketamine appears to be a better
treatment than Spravato in terms of
effectiveness, cost, and convenience. Are you
dealing with treatment-resistant depression? If
you suffer from Treatment resistant depression
(TRD) or major depressive disorder (MDD), SOZO
Centers provide effective esketamine therapy to
help you
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find relief. Esketamine, also known as SPRAVATO,
is an FDA-approved and tested medication that
has been clinically shown to reduce the symptoms
of TRD and MDD. Our providers are dedicated to
helping their patients live healthier, more
fulfilling lives. To learn more about the
benefits of esketamine therapy and how it can
help you manage your condition, contact us today
at SOZO Centers for a consultation. We look
forward to helping you on your journey to better
mental health.