Brand Name: Spravato® (esketamine)
Use: Treats treatment-resistant depression and major depressive disorder with suicidal thoughts.
Form: Nasal spray administered under medical supervision.

NMDA receptor antagonist: Blocks glutamate activity, enhancing synaptic connections.
Promotes neuroplasticity and rapid antidepressant effects, often within hours to days.

Contraindications & Precautions
Contraindications:
Aneurysmal vascular disease
History of intracerebral hemorrhage
Hypersensitivity to esketamine/ketamine

Interactions
CNS depressants (e.g., benzodiazepines, alcohol) → increased sedation
MAO inhibitors → risk of hypertensive crisis
Caution with drugs affecting blood pressure or CNS activity

Adverse Reactions / Side Effects
Common: Dissociation, dizziness, nausea, headache, increased BP, sedation
Serious: Suicidal thoughts, bladder issues (with long-term use), abuse potential

Pregnancy: May cause fetal harm; avoid unless benefits outweigh risks (Category C)
Breastfeeding: Not recommended; excreted in breast milk, effects on infant unknown

Store this medication at 68°F to 77°F (20°C to 25°C) and away from heat, moisture and light. Keep all medicine out of the reach of children. Throw away any unused medicine after the beyond use date. Do not flush unused medications or pour down a sink or drain.

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