Esketamine Nasal Spray: What It Is, How It Works, and What You Need to Know

When you hear Esketamine nasal spray, a prescription nasal spray used to treat severe depression that hasn’t improved with other medications. Also known as Spravato, it’s one of the first new types of antidepressants in decades that works differently than SSRIs or SNRIs. Unlike pills that take weeks to kick in, esketamine can start lifting mood in hours or days—especially for people who’ve tried everything else and still feel stuck.

This isn’t just another antidepressant. It targets the brain’s glutamate system, not serotonin. That’s why it helps people with treatment-resistant depression, a condition where standard antidepressants fail to bring relief—a group that makes up nearly one-third of all depression cases. The nasal spray form lets the drug enter the bloodstream quickly through the nose, bypassing the digestive system. It’s always given under medical supervision because of how fast it works and the potential for side effects like dizziness or dissociation.

It’s not a cure-all. You still need to take an oral antidepressant along with it. And it’s not for everyone—people with uncontrolled high blood pressure, a history of psychosis, or certain brain conditions are usually excluded. But for those who’ve lost hope after years of trying pills, therapy, and even electroconvulsive therapy, esketamine offers a real chance to break through.

What you’ll find in the posts below isn’t a list of ads or vague claims. It’s real, side-by-side comparisons of medications that work for tough mental and physical health conditions—like how methadone stacks up against buprenorphine, or how Rocaltrol compares to other vitamin D analogs. You’ll see how people are managing complex illnesses with smart, evidence-based choices. Esketamine nasal spray fits right into that pattern: a targeted tool for a specific problem, used with care, backed by data, and never sold as a miracle.