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Ketamine nasal spray drug is a form of ketamine, a generic drug that’s been used as a form of anesthesia for many years, Dr. Mikeso always mentions. This ketamine nasal spray, also known as intranasal esketamine, is used as a nasal spray to treat patients with treatment-resistant depression (TRD) and major depressive disorder (MDD). However, the main type of ketamine nasal spray  used is SPRAVATO (esketamine) CIII nasal spray. This type of ketamine is administered in combination with an oral antidepressant.

SPRAVATO is the first prescription nasal spray, taken with an oral antidepressant, for:

• Adults with treatment-resistant depression
• Depressive symptoms in adults with major depressive disorder with suicidal thoughts or actions

Ketamine nasal spray, also known as ketamine or S-ketamine, is the S enantiomer of ketamine, and is a dissociative hallucinogen drug used as a general anesthetic and as an antidepressant for the treatment of depression. It is sold under the brand names Spravato, and Ketanest, among others.

Ketamine nasal spray has also been used for years in smaller doses in IV form for patients with treatment-resistant depression. But as a generic drug, it has not been put through the FDA’s review process for that use.

Buy ketamine nasal spray is actually a controlled substance (it is sometimes abused as a recreational drug — you may have heard it called Special K). Because of that, and because it can create feelings of dissociation and hallucination in people who take it, the new Esketamine nasal spray will only be administered in a doctor’s office or hospital setting. Buy Spravato online.

Buy Ketamine Nasal Spray Online | SPRAVATO For Depression

“It’s a slightly different form of ketamine and will be given as nasal puffs, but the effects are essentially the same,” Dr. Anand says.

A patient will go to their doctor once or twice a week to get nasal puffs of a dose of Esketamine. Because they may experience disorientation or confusion immediately afterward, they will stay at the doctor’s office for two hours. They are also advised not to drive, operate machinery, or undertake a task that requires similar mental effort for the rest of the day.

Esketamine nasal spray appears both effective and fast-acting for treatment-resistant depression,

BUY ESKETAMINE NASAL SPRAY (SPRAVATO) WHICH:

• Adults with treatment-resistant depression (TRD)
• Depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions

• SPRAVATO is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO is safe or effective as an anesthetic medicine.

  It is not known if SPRAVATO is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. SPRAVATO is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of SPRAVATO.

  It is not known if SPRAVATO is safe and effective in children.

What is Ketamine nasal spray | Esketamine for sale promising

One potential benefit of the new drug is that it’s fast-acting. People may notice a relief in symptoms within just a few hours, and it could last for several days, Dr. Anand says. Most oral antidepressants, on the other hand, can take weeks to start working.

That’s because it works in a different way from other depression drugs. “Whereas most other available antidepressants work mainly on the serotonin, norepinephrine, or dopamine systems, ketamine has major effects on glutamate, which is a different neurotransmitter that is much more prevalent in the brain,” Dr. Anand says.

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Ketamine nasal spray is used to treat patients with treatment-resistant depression and major depressive disorder. This is taken when the patient has chronic suicidal ideation and:

• A defined depression diagnosis
• Have well-controlled blood pressure
• Can commit to biweekly visits with a support person for transportation
• Have an established provider managing their care
• Have not found relief from at least 3 initial treatment therapies
• Are seeking an alternative to electroconvulsive therapy (ECT)
• Additional screening criteria

While no formalized definition of treatment-resistant depression currently exists, Treatment Resistant Depression (TRD) is commonly defined as failure of depressive symptoms to respond to both psychological and psychopharmacological interventions. TRD represents the highest direct and indirect medical costs among those with MDD. Individuals with TRD are twice as likely to be hospitalized among those with MDD and have an almost 14% lifetime risk of suicidal behavior compared to 10% for those with MDD.

Those who would not benefit from ketamine as a form of outpatient therapy and would instead be recommended for alternative nonketamine therapies include:

• Patients with active substance abuse (alcohol or drugs)
• Patients with ketamine allergies or insensitivities
• Patients who have depression due to bipolar disorder, schizophrenia or other psychotic disorders
• Patients with uncontrolled hypertensiondue to ketamine’s blood pressure raising effects
• Patients with a known history of an aneurysmal vascular disease, arteriovenous malformations or intracranial hemorrhages

Effectiveness of ketamine nasal spray

Ketamine nasal spray

The full spectrum of ketamine nasal spray antidepressant and ant suicidal effects has not been fully explained. However, we do know that this novel approach to therapy works with the brain’s NMDA receptors, which play a role in several neurological functions like memory, learning, movement and more. This is an alternative to SSRIs (Prozac, Paxil, Zoloft), which work with serotonin receptors.

We also know that ketamine affects other receptors and pathways in the brain, which creates a combination of positive effects that help combat depression.

What Happens During Ketamine Nasal Spray Treatment?

Doctors will begin by assessing the patient, including vital signs, mood and response to previous treatment (if any). Patients will have their blood pressure checked to ensure a proper level since patients with high blood pressure are not eligible for ketamine therapy.

Patients will likely be asked to blow their nose and will then be reclined at a 45-degree angle. The patient is given the nasal spray and self-administers the drug by inhaling the spray in each nostril. After 5 minutes, a second dose will be administered, and then after another 5 minutes an optional third dose will be administered.

After the last dose is inhaled, the patient will be monitored and then periodically assessed for depression, suicidality, hallucinations, dissociation and physical symptoms. The doctor will also keep tabs on the patient’s blood pressure. After the 2-hour mark, the patient will be able to go home with the assistance of a driver if the doctor deems it safe.

For the first 8 weeks of treatment, there are 12 total sessions twice weekly for the first 4 weeks, and then once weekly for the next 4 weeks. After the initial 8 weeks patients can receive treatment as often as once per week or as infrequently as once per month.

Benefits of ketamine nasal spray

Over the last 2 decades, several studies have shown that ketamine produces antidepressant and anti-suicidal effects.

Risks for patients eligible for ketamine therapy are generally minor. Patients are monitored immediately after administration of the spray to check for side effects such as:

• Burning/discomfort
• Dissociation, including out-of-body experience
• Drowsiness/grogginess
• Allergic reaction
• Anxiety or panic
• Blood pressure elevation
• Nausea and vomiting (uncommon)

Most of these side effects wear off quickly and patients usually experience them less frequently as they progress with treatment. Patients are kept under close observation for up to 2 hours after the administration of ketamine nasal spray to ensure safety.

Side effects of ketamine nasal spray (SPRAVATO)

• Abuse and misuse. There is a risk for abuse and physical and psychological dependence with SPRAVATO treatment. Your healthcare provider should check you for signs of abuse and dependence before and during treatment with SPRAVATO.

Tell your healthcare provider if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs.

Your healthcare provider can tell you more about the differences between physical and psychological dependence and drug addiction.

• Sedation and dissociation. SPRAVATO may cause sleepiness (sedation), fainting, dizziness, spinning sensation, anxiety, or feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation).

Tell your healthcare provider right away if you feel like you cannot stay awake or if you feel like you are going to pass out.

Your healthcare provider must monitor you for serious side effects for at least 2 hours after taking SPRAVATO. Your healthcare provider will decide when you are ready to leave the healthcare setting.

• SPRAVATO Risk Evaluation and Mitigation Strategy (REMS).Because of the risks for sedation, dissociation, and abuse and misuse, SPRAVATO is only available through a restricted program called the SPRAVATO Risk Evaluation and Mitigation Strategy (REMS) Program. SPRAVATO can only be administered at healthcare settings certified in the SPRAVATO REMS Program. Patients treated in outpatient healthcare settings (e.g., medical offices and clinics) must be enrolled in the program.
• Increased risk of suicidal thoughts and actions.Antidepressant medicines may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed.

Is ketamine nasal spray (SPRAVATO) use in children?

Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a higher risk of having suicidal thoughts or actions. These include people who have (or have a family history of) depression or a history of suicidal thoughts or actions.

Prevent suicidal thoughts

Pay close attention to any changes, especially sudden changes, in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions.

Tell your healthcare provider right away if you have any new or sudden changes in mood, behavior, thoughts, or feelings.

Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you have concerns about symptoms.

Things to avoid while taking ketamine nasal spray (SPRAVATO)

Do not drive, operate machinery, or do anything where you need to be completely alert after taking SPRAVATO. Do not take part in these activities until the next day following a restful sleep.

Limitations Of The Use Of Ketamine 

SPRAVATO is a prescription medicine, used along with an antidepressant, taken by mouth to treat:

• Adults with treatment-resistant depression (TRD)
• Depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions
• SPRAVATO is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO is safe or effective as an anesthetic medicine.
• It is not known if SPRAVATO is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. SPRAVATO is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of SPRAVATO.
• It is not known if SPRAVATO is safe and effective in children.

Symptoms associated with depression

• Depressed mood or feelings of sadness
• Disrupted sleep
• Lack of interest or inability to feel pleasure (anhedonia)
• Feelings of guilt or hopelessness
• Lack of energy
• Difficulty concentrating
• Changes in appetite or weight
• Slowed thoughts or movements (psychomotor retardation)
• Restlessness and/or purposeless movements (psychomotor agitation)
• Suicidal thoughts or actions

Side Effects

Dizziness, dissociation, dysgeusia (change or distortion in sense of taste), vertigo, and nausea were the most common side effects of the drug. Most tended to occur shortly after dosing and cleared up within 90 minutes. However, the consensus of the study was that overall the drug was safe and tolerable. Buy Esketamine Nasal spray online

An imperfect solution

Beyond potential side effects, ketamine does have additional drawbacks. Though it has been use safely as a short-term anesthetic and in lower doses as a short-term antidepressant, doctors don’t yet understand whether it’s safe and effective to use over many months or years.

“This drug affects a major neurochemical in the brain, and if you interfere with that long-term, we’re not sure what the effects of that are going to be,” Dr. Anand says. “It’s also a drug of addiction, and people can misuse it or overuse it.”

There’s also no guarantee that it will work in all groups of people with treatment-resistant depression. And, like other antidepressants, there’s always the chance that it could make symptoms worse.

Esketamine was studied in five clinical trials leading up to its approval. Only one short-term trial, and its follow-up, longer-term relapse prevention trial of patients who had benefited from ketamine, produced positive results that were statistically significant, Dr. Anand says. Another study focused solely on adults over age 65 and found that the benefit of treatment with antidepressants plus ketamine in that group of patients did not reach statistical significance.

How to store Ketamine

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Buy esketamine spray online

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.