Esketamine
If you’ve been living with treatment-resistant depression or other difficult-to-manage mood symptoms, esketamine may offer a new treatment option.
About Esketamine Treatment
What Is Esketamine?
Esketamine is a fast-acting antidepressant delivered as a nasal spray. It is derived from ketamine and works differently from traditional antidepressants by targeting glutamate, a key neurotransmitter involved in mood regulation.
This different mechanism of action may help improve depressive symptoms more quickly, particularly for people who have not responded to other treatments.
Esketamine is approved for use in Australia under strict prescribing guidelines and is usually used alongside an oral antidepressant.
A comprehensive psychiatric assessment is required before starting treatment.
Who is it for?
Esketamine may be helpful if:
- You have depression that has not responded to at least two antidepressant medications
- You are experiencing severe depressive symptoms, including suicidal thoughts
- You are currently under the care of a psychiatrist
- You are exploring alternative treatment options where other approaches have not been effective, including ECT or inpatient admission
Benefits of Esketamine
Esketamine treatment may offer:
- Rapid onset of action - some people notice improvement within hours to days
- Improved mood and reduced suicidal thoughts
- An alternative option for long-standing depression that hasn’t responded to medication or therapy
Potential Risks and Side Effects
While esketamine is generally well tolerated, some side effects may occur during or shortly after treatment, including:
- Dizziness or light-headedness
- Nausea or vomiting
- Drowsiness or sedation
- Feeling disconnected or “out of body” (dissociation)
- Temporary increases in blood pressure
These effects usually resolve within a few hours after treatment. All sessions are closely monitored by trained clinical staff to ensure client safety and comfort.
Esketamine may not be suitable for individuals with a history of psychosis, uncontrolled high blood pressure, or substance misuse. This will be discussed further with the treating psychiatrist.
What to Expect
Esketamine treatment is delivered in two phases:
Initial phase (Induction)
- Twice-weekly sessions for 4 weeks
- Each session takes approximately 2 hours
- Safe, supervised administration in a clinical setting with medical monitoring
Maintenance phase
- Sessions gradually reduce to weekly, then fortnightly or monthly
- Duration depends on individual response
- Ongoing review with a psychiatrist throughout treatment
After each session, clients will need time to rest and recover. Clients must not drive or return to work immediately after treatment and will need someone to accompany them home.
