US health chiefs approve antidepressant nasal spray derived from ‘party’ drug ketamine

An antidepressant nasal spray derived from the party drug ketamine has been approved by US health chiefs to treat suicidal people.  

Spravato — made by American pharmaceutical and consumer giant Johnson and Johnson — has been given the green light by the Food and Drug Administration.

The decision means doctors across America will now be able to dish out the treatment to patients with suicidal thoughts.

Estimates suggest up to 2million people in the US suffer suicidal thoughts and traditional antidepressants can take weeks to kick in. 

The fast-acting spray — said to work in just four hours — is made from esketamine, a chemical cousin of ketamine which binds to receptors in the brain responsible for mood. 

It comes as the US grapples with a suicide crisis that has seen rates increase by more than a third in the last two decades. Nearly 50,000 Americans now take their own lives each year. 

There is growing fear that more Americans will plunge into depression in the wake of Covid-19 and the economic fallout that proceeds it.  

Spravato was approved after passing two phase 3 clinical trials which showed a significant and rapid reduction in depressive symptoms within 24 hours.

Forty-two per cent of those treated with the nasal spray were cured of their depression within a month, compared with 30 per cent in the placebo group.  

Michelle Kramer, vice president of Johnson & Johnson’s US neuroscience medical affairs unit, said: ‘Relatively rapidly within a few weeks we saw the numbers stabilise, which was pretty interesting for us and validating in the sense that clinics and patients alike were continuing to make this available.

Back in 2006, evidence emerged that ketamine might improve symptoms of depression in some patients (file image) 

‘We certainly see more and more sites sign on and more and more patients are treated.’

Spravato is close in its chemical makeup to the anaesthetic ketamine, which has been shown to have some depression-curing effects itself in small doses.

Ketamine is legally used as a horse tranquilliser and an anaesthetic in emergency departments and battlefields because it rapidly induces a trance-like state – called dissociation.

This helps provide pain relief, sedation, and temporary memory loss that can remedy traumatic experiences.

Esketamine is different from existing antidepressants that target the ‘happy’ brain chemicals seratonin or norepinepherine.

Esketamine acts on the glutamate system, a complex web of receptors responsible for cognition, emotion, and neuroplasticity. This plays a large role in everyday neural functions – like memory. Scientists still aren’t exactly sure why it works so quickly.

America has been struggling to prevent suicide rates from increasing since before the coronavirus pandemic, with the rate rising 30 per cent from 1999 to 2016. 

In 2016, some 44,965 people committed suicide compared with 29,199 in 1999. 

Covid-19 Closures of medical centres has meant that the number of people being given Spravato has been limited.