Spravato

Spravato (esketamine) is an NMDA receptor antagonist and the S-enantiomer of ketamine, approved as a nasal spray for treatment-resistant depression (TRD) in adults and for major depressive disorder (MDD) with acute suicidal ideation or behavior in adults. It must be administered in a certified healthcare setting under direct supervision, with patients observed for at least two hours after each dose due to risks of sedation, dissociation, and misuse. Spravato is used in conjunction with an oral antidepressant. For TRD, it is typically given twice weekly for four weeks, then weekly, then every one to two weeks as maintenance therapy.