Esketamine 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.