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2024-06-11T04:12:39Z

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[[File:Short-term_antidepressant_efficacy_of_esketamine_versus_placebo_added_to_an_existing_oral_antidepressant_in_people_with_depression.png|thumb|Short-term_antidepressant_efficacy_of_esketamine_versus_placebo_added_to_an_existing_oral_antidepressant_in_people_with_depression.png]] [[File:Short-term_antidepressant_efficacy_of_esketamine_versus_placebo_added_to_an_existing_oral_antidepressant_in_people_with_depression_and_suicidality.png|thumb|left|Short-term_antidepressant_efficacy_of_esketamine_versus_placebo_added_to_an_existing_oral_antidepressant_in_people_with_depression_and_suicidality.png]] {{Short description|Medication used for treatment-resistant depression}}
{{Drugbox
| Verifiedfields = changed
| verifiedrevid = 477318705
| IUPAC_name = (2S)-2-(2-chlorophenyl)-2-(methylamino)cyclohexanone
| image = Esketamine.svg
| width = 200
| image2 = Esketamine-3D-balls.png
| width2 = 200
| tradename = Spravato
| Drugs.com =
| MedlinePlus = a619048
| pregnancy_AU =
| pregnancy_US =
| legal_AU = S8
| legal_CA = Schedule III
| legal_UK = Class B
| legal_US = Schedule III
| legal_status =
| routes_of_administration = Nasal spray
| bioavailability =
| protein_bound =
| metabolism = Liver (CYP2B6, CYP3A4)
| elimination_half-life = 7-12 hours
| excretion = Urine
| CAS_number = 33643-46-8
| ATC_prefix = N06
| ATC_suffix = AX27
| PubChem = 123631
| DrugBank = DB01221
| ChemSpiderID = 110146
| UNII = 50LFG48P1T
| KEGG = D09373
| ChEBI = 61007
| ChEMBL = 1201208
| IUPHAR_ligand = 4299
| C=13 | H=16 | Cl=1 | N=1 | O=1
| smiles = ClC1=CC=CC=C1[C@@H](C2(NC)CCCCC2)=O
| StdInChI = 1S/C13H16ClNO/c1-15-12(13(16)10-6-2-3-7-10)9-4-5-8-11(14)12/h4-5,8-10,15H,2-3,6-7H2,1H3/t12-/m0/s1
| StdInChIKey = YQEZLKZALYSWHR-LBPRGKRZSA-N
}}

'''Esketamine''', sold under the brand name '''Spravato''', is a [[medication]] used for the treatment of [[treatment-resistant depression]] (TRD). It is a [[stereoisomer]] of [[ketamine]], specifically the S(+) enantiomer. Esketamine is administered as a [[nasal spray]] and works as a [[NMDA receptor antagonist]].

== Medical uses ==
Esketamine is primarily used for [[treatment-resistant depression]] in adults who have not responded adequately to at least two different [[antidepressant]] treatments. It is often used in conjunction with an oral antidepressant.

== Mechanism of action ==
Esketamine acts as a [[NMDA receptor antagonist]], which is believed to contribute to its rapid antidepressant effects. By blocking the NMDA receptor, esketamine increases the levels of [[glutamate]] in the brain, which in turn activates [[AMPA receptors]] and leads to the release of [[brain-derived neurotrophic factor]] (BDNF). This cascade of events is thought to contribute to the synaptic plasticity and antidepressant effects observed with esketamine.

== Side effects ==
Common side effects of esketamine include [[dissociation]], [[dizziness]], [[nausea]], [[sedation]], [[vertigo]], and [[increased blood pressure]]. Due to its potential for abuse and dissociative effects, esketamine is classified as a [[Schedule III controlled substance]] in the United States.

== History ==
Esketamine was approved by the [[U.S. Food and Drug Administration]] (FDA) in March 2019 for the treatment of treatment-resistant depression. It was developed by [[Janssen Pharmaceuticals]], a subsidiary of [[Johnson & Johnson]].

== Related pages ==
* [[Ketamine]]
* [[Antidepressant]]
* [[NMDA receptor antagonist]]
* [[Treatment-resistant depression]]
* [[Brain-derived neurotrophic factor]]

[[Category:Antidepressants]]
[[Category:NMDA receptor antagonists]]
[[Category:Schedule III controlled substances]]
[[Category:2019 introductions]]
[[Category:Johnson & Johnson brands]]

{{Psychotropic-drug-stub}}

Esketamine - Revision history

Prab: CSV import