This treatment is for those with depression who have failed at least two antidepressants. Patients will be required to have someone drive them home and will need to stay in our office for two hours. The initial treatment consists of twice weekly treatments for four weeks and then treatment once weekly. Ongoing treatment is usually required, which is what we also see with IV ketamine. The long-term safety study showed that esketamine was generally tolerable, with no new safety signals with dosing up to 52 weeks.

Ketamine has been hailed as the most important advancement in the treatment of depression in the past 50 years. Ketamine works on the NMDA receptor and modulates glutamate instead of serotonin, norepinephrine, and dopamine like traditional antidepressants. It is thought to help restore nerve synaptic connections in brain cells in people with major depressive disorder. It also works faster than other antidepressants. Patients often report symptom improvement in days instead of weeks. Suicidality also often improves rapidly.

“We’ve always prided ourselves in offering the most advanced treatments to our patients,” Dr. Prashad said. “Insurance coverage of esketamine will allow this life-saving treatment to be accessible to patients that need it. With one-third of those suffering from depression unable to respond to antidepressant medications, being able to provide relief to patients that are otherwise treatment resistant is a great opportunity.”