esketamine
Adjunctive therapy • Brands: Spravato
Last reviewed: 2025-12-30
General information
- Class: Adjunctive therapy
- Common US brands: Spravato
- Therapeutic drug monitoring not routinely recommended.
- Last reviewed: 2025-12-30
Dosing & forms
- Forms/strengths: —
- Frequency: —
- Food: —
- Typical range: —
Mechanism (brief)
Intranasal NMDA receptor antagonist (esketamine) used under a REMS for treatment-resistant depression and depressive symptoms in major depressive disorder (MDD) with acute suicidal ideation/behavior; administered in a certified healthcare setting due to sedation, dissociation, respiratory depression, and abuse/misuse risk.
Metabolism & Half‑life
- Metabolism: CYP2B6, CYP3A4, CYP2C9, CYP2C19
- Half‑life: Single-dose range 7–12 h
Therapeutic Drug Monitoring (TDM)
Recommended: No
Monitoring highlights
- —
Sources
- SPRAVATO (esketamine) nasal spray prescribing information — DailyMed (2025)
- Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined With a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study — American Journal of Psychiatry (2019)
- AGNP TDM Consensus — Pharmacopsychiatry (2018)
- APA Clinical Practice Guideline for the Treatment of Depression — American Psychiatric Association (2023)