Esketamine Therapy

Esketamine is a prescription medication frequently used with an oral antidepressant to treat adults with treatment-resistant depression, or adults with major depressive disorder (MDD) with suicidal thoughts or actions. It is not used to prevent or relieve pain.

After an evaluation, your health care provider will determine your prescription and when you will take it. Our provider will show you how to use the Esketamine nasal spray device. The treatment is taken under the supervision of a registered nurse or nurse practitioner. If you miss a treatment, your health care provider may change your dose and/or treatment schedule.

Some patients taking Esketamine experience nausea and vomiting. You should not eat for at least two hours and not drink liquids for at least 30 minutes before treatment.

If you take a nasal corticosteroid or nasal decongestant medicine, take these medicines at least one hour before your treatment.

Your health care provider will monitor you for at least two hours after treatment and will decide when you are ready to leave.

Common side effects

  • Feeling disconnected from yourself, your thoughts, feelings and things around you
  • Dizziness
  • Nausea
  • Feeling sleepy
  • Spinning sensation
  • Decreased feeling of sensitivity (numbness)
  • Feeling anxious
  • Lack of energy
  • Increased blood pressure
  • Vomiting
  • Feeling drunk, very happy or excited

Serious side effects

  • Sedation and dissociation including sleepiness, fainting, dizziness, spinning sensation, anxiety or feeling disconnected from yourself, your thoughts, feelings, space and time
  • There is a risk for abuse and misuse: your health care provider should check you for signs of abuse and dependence before and during treatment
  • Increased risk of suicidal thoughts and actions. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Antidepressant medicines may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Esketamine is not for use in children.

Restrictions while receiving Esketamine treatment

Individuals who receive Esketamine therapy should not drive, operate machinery or participate in any activities that requires you to be alert on the day of treatment. You will need to plan for a caregiver or family member to drive you home. You should not take part any activity until the following day.

Insurances accepted

A list of insurance we accept are here ( Please call our department (714-744-8879) to verify your coverage.

Medication management

Your psychiatrist will continue to manage your medication while receiving Esketamine treatment.

Information for providers

Patients should be referred for consultation by their psychiatrist. Please contact the NETS Department Nurse Navigator, 714-744-8879, for information on patient referrals.