SpravatoEsketamine nasal spray is used along with another antidepressant, taken by mouth, to manage treatment-resistant depression (TRD), depression that does not improve with treatment. Esketamine is in a class of medications called NMDA receptor antagonists. It works by changing the activity of certain natural substances in the brain.

Patients with major depressive disorder who, despite trying at least two antidepressant treatments given at adequate doses for an adequate duration in the current episode, have not responded to treatment are considered to have treatment-resistant depression.

Esketamine, which is marketed under the name Spravato®, was approved for use by the U.S. Food and Drug Administration in 2019. Due to the FDA’S concerns for safety, it can only be used under medical supervision with specific restrictions. It is administered under the supervision of a physician and the patient is monitored for a minimal of two hours at the facility before being discharged. Since it is FDA approved, Spravato is covered by some insurance plans.