What is a critical safety requirement for administering esketamine?

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Administering esketamine requires a critical safety requirement to be conducted in a supervised healthcare setting due to its potential for sedation and dissociation. Esketamine, a nasal spray formulation developed for treatment-resistant depression, can cause significant side effects that necessitate close observation by healthcare professionals. When administered in a controlled environment, the staff can monitor the patient for respiratory and cardiovascular effects, as well as any adverse reactions, ensuring prompt intervention if needed.

This setting is designed to provide immediate assistance and support if the patient experiences dizziness, syncope, or any other concerning symptoms post-administration. Furthermore, the controlled environment helps to safely guide patients through the experience of the drug's psychoactive effects, ensuring that they do not engage in potentially dangerous activities such as driving or operating machinery immediately after treatment.

In contrast, home administration could lead to risks due to lack of supervision. Daily dosing isn't a part of the established treatment plan for esketamine; it is typically given once or twice per week during the initial phase and then can be adjusted based on response. Co-administration with antidepressants is common, but not necessarily a critical safety requirement, as it depends on the individual's treatment plan and clinical judgment of the prescribing clinician.

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