In 2019, a ketamine-based antidepressant raised hopes and concerns
For the first time in decades, a fundamentally new drug became available for people with severe depression. A nasal spray called Spravato offers a new option for treating people whose depression hasn’t responded to other approaches. But there are still big questions about the drug’s effectiveness and safety (SN: 4/13/19, p. 8). 102019 Top 10See full list In March, the U.S. Food and Drug Administration approved Spravato. The drug contains esketamine, one of two mirror-image molecules that make up the drug ketamine. Developed decades ago as a powerful anesthetic, ketamine is also a hallucinogen co-opted by ravers and other partiers for its swirly, out-of-body highs. Many existing antidepressants target serotonin, a chemical messenger in the brain involved in mood. Scientists think ketamine and its relatives affect a different chemical messenger, glutamate, sometimes within hours. For all the fanfare over Spravato’s approval, ketamine’s power to quickly turn around severe depression in some people has been known for years....