What is esketamine (Spravato) primarily used for?

Esketamine (Spravato) is primarily used in the treatment of major depressive disorder, specifically for patients who exhibit acute suicidal ideation. This medication is a nasal spray formulation of ketamine, which has shown rapid antidepressant effects, especially in treatment-resistant cases. Traditional antidepressants can take weeks to provide relief, whereas esketamine can offer quicker alleviation of symptoms, making it particularly valuable for individuals at risk of suicide.

The mechanism of action involves antagonism of the NMDA receptor and enhancement of synaptic connectivity, which contributes to its rapid efficacy in reducing depressive symptoms. By addressing acute suicidal thoughts, esketamine provides a critical intervention for patients who need immediate support while further treatment options are explored or any necessary stabilization measures are implemented.