Fast-Acting Depression Drug (Spravato — Esketamine Nasal Spray), Newly Approved

[85dB T]

Fast-Acting Depression Drug, Newly Approved, Could Help Millions
A nasal spray version of the drug ketamine has shown promise as an antidepressant, even if its properties still aren't well understood.

https://www.nytimes.com/2019/03/05/health/depression-treatment-ketamine-fda.html

 

[ajc]

Well that's cheap!

The cost for a one-month course of treatment will be between $4,720 and $6,785, said Janssen, and experts said it will give the company a foothold in the $12 billion global antidepressant market, where most drugs now are generic.

 

[sirhand]

I've tried plenty of antidepressants but none of them gave the feeling of contentment that I got when I tried ketamine. It would make a great antidepressant.

 

[newarrior]

Great news!

 

[JohnAdams]

Why is it so expensive? You could probably get it cheaper on the black market.

 

[85dB T]

Why is it so expensive? You could probably get it cheaper on the black market.

Below is more information as to possibly why. It can cause hallucinations in some people so supervision is required during the first month. Subsequent treatments cost half as much.

I was prescribed Zolpidem (Ambien) for insomnia. This caused hallucinations and paranoia, big time. So WARNING.

"Spravato will not be dispensed directly to a patient to take at home," he said. "It will only be available in approved and certified treatment centers." Patients will inhale the drug under supervision at these centers once or twice a week. And they will receive a dose that is unlikely to produce side effects such as hallucinations. "The amount of active ingredient that's in this product, it's at a very, very low dose," Billington said.

Johnson & Johnson said the wholesale cost of each treatment with esketamine will range from $590 to $885, depending on the dose. That means twice-weekly treatments during the first month will cost centers that offer the drug at least $4,720 to $6,785. Subsequent weekly treatments will cost about half as much.

 

[RB2014]

You can't drive for two afters and hallucinations.... Sign me up!!!!

 

[OnceUponaTime]

even if its properties still aren't well understood

Ok then...lol

 

[Cal18]

I don't think it's that expensive, I just received a newsletter announcement from a local medical office office in San Diego - "Our first Spravato patients will be starting next week, and all 3 of them are paying less than $40 out of pocket per treatment."

I read one of the side effects during use is tinnitus but I think that's also listed as a side effect for infused Ketamine which, as we know, has helped some people.

 

[JohnAdams]

I don't think it's that expensive, I just received a newsletter announcement from a local medical office office in San Diego - "Our first Spravato patients will be starting next week, and all 3 of them are paying less than $40 out of pocket per treatment."

I read one of the side effects during use is tinnitus but I think that's also listed as a side effect for infused Ketamine which, as we know, has helped some people.

So get tinnitus from a depression drug used to treat depression from tinnitus?

 

[linearb]

Well that's cheap!

The cost for a one-month course of treatment will be between $4,720 and $6,785, said Janssen, and experts said it will give the company a foothold in the $12 billion global antidepressant market, where most drugs now are generic.

Haha. Meanwhile, the cost of getting yourself a gram of near-USP-grade ketamine and just making your own nasal spray is like $100 or less

 

[linearb]

I read one of the side effects during use is tinnitus but I think that's also listed as a side effect for infused Ketamine which, as we know, has helped some people.

Helped people for depression, or tinnitus? I know one person on here who tried it for the latter and had a quite negative experience, and none of the practitioners I've spoken to have much experience with tinnitus. One person said they'd had a single patient who seemed to improve but he was also doing rTMS and a bunch of other stuff.

The evidence for depression is certainly more compelling, so maybe this could help with some of the mood-change issues associated with tinnitus, but I'm pretty skeptical. Anecdotally I know a few people with tinnitus who occasionally snort ketamine and they have told me it either has no effect, or tends to make the tinnitus worse for a while.

I haven't seen Ketamine since the early '00s, but early on with my worse tinnitus I experimented with the kind-sorta similar drug MXE and immediately concluded that it made my ringing worse.

 

[Piney]

They always comment they need more studies. We'll get enough studies then release the paper, and what about the side effects of psychotic episodes, that sounds like a seriously bad effect. I Thought they couldn't really tell if a person was depressed by looking at their brain scans, maybe I'm wrong. Get sick of hearing about these treatments that never say 100% percent cured or we need more data. Maybe Jerry Garcia had it right just eat a 10 pound bag of mushrooms and see what happens probably the same thing.

 

[Piney]

I think I'm just having a bad day, if it helps some people that's great.

 

[AVIYT]

They always comment they need more studies. We'll get enough studies then release the paper, and what about the side effects of psychotic episodes, that sounds like a seriously bad effect. I Thought they couldn't really tell if a person was depressed by looking at their brain scans, maybe I'm wrong. Get sick of hearing about these treatments that never say 100% percent cured or we need more data. Maybe Jerry Garcia had it right just eat a 10 pound bag of mushrooms and see what happens probably the same thing.

I think psilocybin can be a great healing tool, but I'm more a proponent of microdosing. Tripping and microdosing are 2 complete separate worlds and unfortunately for some they may not feel okay with tripping. 10 grams dried or wet also makes a difference. 10 grams wet is similar to 1 gram dried, so if someone were to eat 10 grams dried... yikes. That's like a heroic dose.

For people like me, who are EXTREMELY sensitive to psychedelics, even a microdose of ".2grams" is too much. I can trip fully.

 

[AVIYT]

Ketamine is great but unfortunately it's insanely overpriced. If you know a doctor, and can find a source of Ketamine (whether it be legal or from the darknet) you can buy a vial for $50 or $100. And then if you have the instructions for dosing, it can be done in a calm situation, maybe with just the doctor or even include a therapist or someone you trust who'd be on board and voila.

Paying $450-700 per infusion is not worth it, and of course insurance won't cover it for years.

 

[Lane]

They always comment they need more studies. We'll get enough studies then release the paper, and what about the side effects of psychotic episodes, that sounds like a seriously bad effect.

Hmmm, psychotic episodes... I would agree @Piney, that doesn't sound good. But perhaps not as bad as death (see below). Here's a link to an article I just perused, with a snippet below:

Caution urged over use of fast-acting version of ketamine for depression -- Critics say the drug manufacturer only provided, at best, modest evidence the drug worked and then only in limited trials. -- June 11, 2019, 6:54 AM PDT -- By Emmarie Huetteman, Kaiser Health News

The problem, critics say, is that the drug's manufacturer, Janssen, provided the FDA at best modest evidence it worked and then only in limited trials. It presented no information about the safety of Spravato for long-term use beyond 60 weeks. And three patients who received the drug died by suicide during clinical trials, compared with none in the control group, raising red flags Janssen and the FDA dismissed.

The FDA, under political pressure to rapidly greenlight drugs that treat life-threatening conditions, approved it anyway. And, though Spravato's appearance on the market was greeted with public applause, some deep misgivings were expressed at its day-long review meeting and in the agency's own briefing materials, according to public recordings, documents and interviews with participants, KHN found.

Dr. Jess Fiedorowicz, director of the Mood Disorders Center at the University of Iowa and a member of the FDA advisory committee that reviewed the drug, described its benefit as "almost certainly exaggerated" after hearing the evidence.​