Q • I was a participant in a phase 3 clinical trial for esketamine, which came to market as the nasal spray Spravato. The Food and Drug Administration approved it for treatment-resistant major depression, a condition I’ve suffered from for 15+ years.
The effect was profound: an immediate relief of all suicidal ideation and brain fog, and great improvement in mood. When the study ended, I relapsed within a month.
My psychiatrist then prescribed generic ketamine, compounded as a nasal spray by a local pharmacy. It cost about $50 for a month’s supply. RELIEF again, and no hallucinations or negative side effects.
Despite the positive effects, my doctor was uneasy about prescribing ketamine off-label and stopped. Spravato came on the market, but it’s prohibitively expensive — about $4,000-$6,000 a month for the dose/frequency I need. I am currently as depressed as I’ve ever been. It’s heartbreaking to know that the ketamine cure is out there, but I cannot access it.
A • Ketamine was developed as an injectable anesthetic agent and approved by the FDA in 1970 under the brand name Ketalar. It is still used as an anesthetic.
In 2002, Japanese researchers reported that small doses of ketamine “improved the postoperative depressive state and relieved postoperative pain in depressed patients” (Anesthesia and Analgesia, July 2002). Since then, many other studies have shown that this old medication appears to have fast-acting antidepressant activity.