What Esketamine Treatment Is
Esketamine is a specific, more concentrated form of ketamine that works effectively at lower doses than the original compound. The chemical difference lets a psychiatrist deliver a strong antidepressant effect with less risk of misuse. The U.S. Food and Drug Administration approved esketamine in 2019 under the brand name Spravato, and The Valens Clinic gives it as a nasal spray under medical supervision. It targets two specific conditions: treatment-resistant depression and major depressive disorder with suicidal thoughts.
Why It Works Faster Than Standard Antidepressants
Standard antidepressants such as SSRIs and SNRIs can take weeks to show a measurable effect. Esketamine works within hours instead. It acts on NMDA receptors and influences glutamate, a brain chemical central to mood regulation, and raises brain-derived neurotrophic factor, a protein that helps brain cells grow and adapt. Speed matters most in an emergency: esketamine can improve symptoms within a few hours and sometimes helps a patient avoid hospital admission altogether.
Who Esketamine Treatment Suits
Esketamine treatment is not a first-line option. A psychiatrist considers it once standard medication and therapy have not brought enough improvement, or when a patient’s suicidal thoughts need a faster response than a typical antidepressant can offer. It usually continues alongside other medications, and a psychiatrist adjusts the wider plan as esketamine takes effect.
What Happens During a Supervised Session
Every esketamine session happens under close medical supervision, since the nasal spray can cause temporary side effects. A patient may feel dissociation, lightheadedness, drowsiness or nausea, notice a brief rise in blood pressure, or perceive colours, sounds and light slightly differently for a short while. The Valens Clinic uses a quiet, comfortable room with monitoring equipment throughout each session, and a patient stays at the clinic for about two hours afterwards to recover safely. A patient should not drive again until the day after treatment.
Before a Session Begins
A few practical steps make a session more comfortable. A patient skips food and caffeine for a few hours beforehand, since fasting sharpens the drug’s effect and reduces side effects, and avoids other nasal sprays so the esketamine dose absorbs properly. A clear nasal passage beforehand matters for the same reason.
Esketamine Paired With Therapy
The dissociation esketamine causes briefly can open a useful window for therapy. Guided psychotherapy given during or soon after a session, delivered only by a trained professional, can strengthen the results esketamine produces alone. Unlike psychedelic drugs, the dissociation esketamine causes stays mild and short-lived for most patients.
How a Treatment Plan Progresses
A typical plan starts with two sessions a week for the first month, then moves to a single weekly session as symptoms respond. A psychiatrist adjusts frequency and dosage as a patient responds, and works toward lasting relief while fine-tuning any other medication already in place. A single session can ease symptoms quickly during a crisis, though lasting improvement depends on continuing treatment and a longer-term plan against relapse.
When a Psychiatrist Recommends Esketamine Treatment
A psychiatrist at The Valens Clinic reviews what a patient has already tried before recommending esketamine. History, current symptoms and how a patient has responded to standard medication all factor into the decision, alongside the specific criteria for treatment-resistant depression or major depressive disorder with suicidal thoughts. The goal is a plan built around what a patient has tried, not a treatment offered by default.
Ask About Esketamine Treatment
Book a consultation about esketamine treatment at The Valens Clinic to find out whether treatment-resistant depression responds to this faster-acting option.