New fast-acting antidepressant nasal spray raises concerns
SARASOTA COUNTY - Last week, the FDA approved a new antidepressant for the first time in years after a 14-2 vote. Experts say the drug is a last resort for those who have tried everything.
Esketamine raises eyebrows due to its relationship to Ketamine, also known as a hallucinogenic club drug, Special K. Nearly one-third of Americans suffer from some form of depression;some turn to medication to fight the second leading cause of death.
Sarasota Clinical Psychologist, Dr. Eddy Regnier said, "Up until now, the medications we've had. We had sort of two major ones, Tricyclics and SSRI medications." Those drugs are prescribed under brand names like Lexapro, Prozac, and Norpramin. Dr. Regnier said before feeling their positive effects, it could take four to six weeks of negative side effects. "...cause people to feel tense, can feel anxious, can have an upset stomach, can keep you up at night, can lower sex drive, can create stiffness in the muscles," he said.
But a new drug approved by the FDA last week, could have you feeling your best self in just 24 hours. Esketamine, a nasal spray sold under the brand name, Spravato. "The problem is the drug hasn't been around very long. We don't have very much experience with it. Esketamine seems to target Glutamate, which is the neurotransmitter that is associated with learning and memory, rather than Serotonin that the Tricyclics and SSRIs target," he said.
Like other antidepressants, there are side effects. He said,"When it is first used, it can increase suicidal thoughts and we know that depression–related suicide is the leading cause of death for patients with depression." That's why patients must pair it with a second oral antidepressant.
Dr. Regnier said its long–term effects are unknown. Esketamine is of the fastest drugs he has seen gain approval by the FDA. "Most drugs before we use them have had at least two or more double–blind study research to sort of clear its use. This one, it's only had one," he said.
Dr. Regnier recommends taking a holistic approach before turning to medication.
"You have to make life changes: drink less, exercise more, eat more rationally, a Mediterranean Diet. Keep good friends, stay out of stress, and you will minimize your risk for depression," he said.