Spravato
Ketamine is a racemic compound made up of equal parts of its two enantiomers, (S)-ketamine and (R)-ketamine. “What on earth does that mean?” Think of it this way, the ketamine we normally use in an IV for general anesthesia and in low doses to treat mental health disorders and chronic pain is made up of a pair of molecules. These two molecules are mirror images of one another, much like our hands. While they are mirror images, the molecules are not identical. The esketamine molecule is actually more potent at the NMDA receptor which is believed to be the main site of action of ketamine. Johnson and Johnson isolated the “left hand” of ketamine or, eskatemine, and created the nasal spray, Spravato.
Spravato is FDA approved for adults with treatment resistant depression (TRD) or with major depressive disorder with acute suicidal ideation or behavior (MDSI). Spravato may be a good option for those who have insurance as it is covered by most carriers. Please see our FAQs section for more information regarding Spravato.
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