Spravato™ was approved by the FDA in 2019 as an additional therapy option for the management of treatment-resistant depression. Also known as esketamine, Spravato™ aids in the restoration of synaptic connections in the brain. Like its parent compound ketamine, this drug targets a different brain mechanism compared to traditional antidepressants making it able to provide robust and rapid relief from depression symptoms.
Because Spravato™ and ketamine are cut from the same cloth, so to speak, it is important to understand exactly how they are similar and how they differ. Here are some facts for consideration to help you understand these two treatment options and whether one may be a good choice for treating your depression.
The first step to understanding these two drugs is to look at the chemistry behind them. Ketamine is a racemic mixture which means that it is comprised of two mirror-image molecules R-ketamine and S-ketamine that exist together and spin in separate directions. If you separate the mixture, each molecule on its own is called an enantiomer. When it comes to esketamine, the developers isolated one of ketamine’s enantiomers, the S-enantiomer. They chose this particular one because they found it to be more potent and that it binds better to a certain brain receptor which is known to play a part in depression.
As for research, it is still ongoing. These drugs continue to provide rapid relief from symptoms for those who suffer from treatment-resistant depression. Scientists believe that both drugs act as NMDA receptors allowing for the restoration of proper glutamate levels in the brain. When the correct balance of neurotransmitters is established, the brain is restored to a healthier state and improvements in mood are experienced.
Now let’s take a look at these two drugs head-to-head:
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