FDA approves ketamine nasal spray for severe depression treatment

WOODBURY, Minn. (FOX 9) - For years, the drug "Special K" has been known as a potentially dangerous illegal party drug, but now the FDA has approved its use for severe depression.

Ketamine can cause hallucinations and distorts sights and sounds. The drug induces feelings of calmness and relieves pain, while your body feels out of control. It can also spike your blood pressure.

However, medical experts say ketamine has a legitimate use. It’s used as a sedative for pain. The FDA’s new approval to use the drug for severe depression comes with very clear restrictions. For this use, it comes in the form of a nasal spray called esketamine and it is not a prescription you will be able pick up at your neighborhood pharmacy.

Dr. Steve Meisel, the director of medication safety at Fairview Health Services, was the only Minnesota doctor on the FDA panel that recommended the drug’s approval.

“The patient will have to come of the office, although they self-administer the nasal spray – one spray into each nostril – perhaps two sprays into each nostril,” said Dr. Meisel. “They will then have to sit there for two hours after the dose to make sure the side effects, the immediate side effects abate.”

The patient will not be allowed to drive until the next day. It’s a big inconvenience, especially when you consider the patient likely starts off with two doses a week, which then decrease over time. The long-term effects are simply unknown.

“What’s the long-term effect of that temporary spike in blood pressure? Week after week after week and year after year after year on heart attacks or strokes, whatever those things cause - we don’t know. And we wont know for a very long time,” said Dr. Meisel.

Esketamine is for patients who do not have success with standard anti-depressants, but Dr. Meisel makes it very clear it is not a wonder drug.  

“A minority of patients who received this drug actually benefited from it, but for those who did, it was life-changing, and in some cases life-saving,” he said.

The biggest obstacle is going to be for those who live in rural areas where the patient has to travel long distances to find a doctor who administers esketamine. Dr. Meisel thinks eventually the restrictions might have to be adjusted to accommodate those patients.