Used for Depression

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Manufactured by various FDA-approved generic manufacturers.

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Updated on 24 Apr 2024

Learn more about esketamine

What dosages is esketamine available in?

What dosages is esketamine available in?

esketamine is available as 28 mg of esketamine per device. Each nasal spray device delivers two sprays containing a total of 28 mg of esketamine.

What is esketamine used for?

What is esketamine used for?

esketamine is a NMDA receptor antagonist and is used for the following:

  • Treatment-resistant depression (TRD) in adults
  • Major depressive disorder in adults with suicidal ideation or behavior (MDSI)
How does esketamine work?

How does esketamine work?

esketamine is a N-methyl-D-aspartate (NMDA) receptor antagonist. It’s not exactly known how the medication works to help with depression. But it’s thought to balance the chemicals and signaling pathways in your brain that are involved with regulating your mood.

How do I take esketamine?

How do I take esketamine?

esketamine is given as a spray into the nose at a provider’s treatment center. Each device contains 1 spray for each nostril and a total of 28 mg of esketamine.

  • esketamine is typically used along with an antidepressant that’s taken by mouth

Treatment-resistant depression (TRD):

  • Weeks 1 to 4: The typical starting dose is 56 mg sprayed into the nose on day 1. After the first day, the dose is 56 mg or 84 mg twice per week.
  • Weeks 5 to 8: The typical dose is 56 mg or 84 mg sprayed into the nose once per week
  • Week 9 and beyond: The typical dose is 56 mg or 84 mg sprayed into the nose once every week or every other week, depending on how you respond to the medication
  • Major depressive disorder with suicidal ideation or behavior (MDSI): The recommended dose is 84 mg sprayed into the nose twice per week for 4 weeks (1 month). The dose can be lowered to 56 mg twice per week if you’re having side effects. After 1 month of treatment, your provider will decide whether you should continue treatment with esketamine based on how well you’re responding to the medication
Is it safe for me to take esketamine?

Is it safe for me to take esketamine?

esketamine is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication in the following:

  • Aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial and peripheral arterial vessels) or arteriovenous malformation.
    Intracerebral hemorrhage
  • Hypersensitivity to esketamine, ketamine, or any of the excipients
esketamine Common Side Effects

esketamine Common Side Effects

Common side effects of esketamine:

  • Dissociation
  • Dizziness
  • Nausea
  • Sleepiness
  • Vertigo
  • Headache
  • Changes in taste
  • Numbness
  • Anxiety
  • Feeling sluggish
  • Higher blood pressure
esketamine Serious Side Effects

esketamine Serious Side Effects

Serious side effects are rare with esketamine. Contact your healthcare provider immediately if you experience any of the following.

  • Extreme sleepiness
  • Dangerously slow breathing: trouble breathing; bluish-colored lips, fingers, or toes
  • Suicidal thoughts and behaviors: anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness
  • Extremely high blood pressure: chest pain, shortness of breath, severe headache, visual changes
Effects of other drugs, drug classes and over-the-counter products on esketamine

Effects of other drugs, drug classes and over-the-counter products on esketamine

The following medications may interact with esketamine:

  • Concomitant use with CNS depressants (e.g., benzodiazepines, opioids, alcohol) may increase sedation. Closely monitor for sedation with concomitant use of esketamine with CNS depressants
  • Concomitant use with psychostimulants (e.g., amphetamines, methylphenidate modafinil, armodafinil) may increase blood pressure. Closely monitor blood pressure with concomitant use of
  • esketamine with psychostimulants
  • Concomitant use with monoamine oxidase inhibitors (MAOIs) may increase blood pressure. Closely monitor blood pressure with concomitant use of esketamine with MAOIs
Who makes esketamine?

Who makes esketamine?

Various FDA-approved generic manufacturers

Is esketamine safe in pregnancy?

Is esketamine safe in pregnancy?

esketamine is not recommended during pregnancy. There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants, including esketamine, during pregnancy. Healthcare providers are encouraged to register patients by contacting the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or online at women’s health


What to do if you missed your esketamine dose

The FDA's medical product safety reporting program for health professionals, patients and consumers.

Learn more about reporting side effects
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Medical Disclaimer

NowPatient has taken all reasonable steps to ensure that all material is factually accurate, complete, and current. However, the knowledge and experience of a qualified healthcare professional should always be sought after instead of using the information on this page. Before taking any drug, you should always speak to your doctor or another qualified healthcare provider.

The information provided here about medications is subject to change and is not meant to include all uses, precautions, warnings, directions, drug interactions, allergic reactions, or negative effects. The absence of warnings or other information for a particular medication does not imply that the medication or medication combination is appropriate for all patients or for all possible purposes.

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