A nasal spray could be a new way to tackle depression. Based on a horse tranquilliser, the spray gets to work in as little as two hours, far quicker than widely used medications that can take weeks to kick in.
The liquid contains a compound called esketamine, which is thought to act on the brain chemical glutamate to restore connections between brain cells. It’s used in far smaller doses than the street drug ketamine.
The U.S. regulator, the Food and Drug Administration, last week approved the use of the spray for patients with depression that does not respond to other treatments.
Five UK centres are taking part in a long-term trial of the spray, which is used twice a week. Depression is a mood disorder that causes persistent feelings of sadness and loss of interest. Clinical depression is estimated to affect one in 15 adults at some time.
It is the result of changes in brain chemistry, and causes range from genetics and changes in hormone levels, to chronic medical conditions, stress and grief.
The most common treatments are drugs called selective serotonin reuptake inhibitors (SSRI). These work for some — not all — patients, and can take between two and six weeks to exert full effects. A study of 3,000 cases of severe depression in the American Journal of Psychiatry found that less than 30 per cent had remission after taking SSRIs.
A nasal spray has been investigated, as it offers quicker relief because the drug gets to where it is needed in the brain without being processed through the body.
