Ketamine Isomer S

S-ketamine, also known as esketamine, is the S-enantiomer of ketamine and is used primarily for treating treatment-resistant depression. It was approved by the FDA as a nasal spray on March 5, 2019. Ketamine is a chiral molecule with two enantiomers: S-ketamine (the left-handed orientation) and R-ketamine (the right-handed version). S-ketamine works by increasing glutamate levels in the brain, which helps stabilize mood and enhance cognition.

Types Of Ketamine: S-Ketamine

S-ketamine (esketamine), sold under the brand name Spravato, is the S-enantiomer of ketamine. The FDA approved it, as a nasal spray, on March 5, 2019 for treatment-resistant depression (depression that has not responded to antidepressant medications).

The FDA recommended approval after reviewing four clinical trials looking at Spravato nasal spray for treatment-resistant depression. These were three short-term trials and one long-term one. One of the short-term trials showed statistically significant antidepressant effects compared to placebo.

In the longer-term trial, patients in stable remission following Spravato who continued treatment with Spravato and an antidepressant were free of depression for longer than patients who were given a placebo nasal spray plus the antidepressant.

On August 3, 2020, the FDA also approved Spravato for the treatment of major depressive disorder (MDD) with acute suicidal ideation or behavior.

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Janssen Pharmaceuticals, Inc., a subsidiary company of Johnson & Johnson, makes esketamine, selling it as a prescription under the brand name Spravato.

Due to restrictions, it is only available to patients in the presence of a healthcare provider in a medical setting. You cannot get a prescription to esketamine nasal spray, take it home with you, and administer the ketamine on your own.

Compared to R-ketamine (which we will explore next), esketamine is a more potent psychoactive drug. It induces greater dissociative effects and dopaminergic activity. This means taking this drug is more likely to lead to effects like feeling detached from your body, your surroundings, and your sense of self.

Its affinity for the NMDA receptor and anesthetic potency is four times greater. In addition, the body removes S-ketamine more quickly than racemic ketamine or R-ketamine.