While the science behind esketamine is revolutionary, the practical realities of the treatment involve a unique commitment from the patient. Therapy is not a daily pill taken at home; it is an intensive, in-clinic medical procedure.
The Treatment Schedule
The initial phase of esketamine treatment is typically high-frequency, often involving twice-weekly treatments for the first four weeks. This is followed by a maintenance phase, where treatments might drop to once weekly, and eventually to every two weeks, based on the patient’s response and clinical stability. The entire process requires consistent scheduling and reliable transportation, as patients are strictly prohibited from driving until the day after treatment due to the lasting effects of sedation or dissociation.
Side Effects and Monitoring
During the two-hour post-administration observation period, healthcare providers closely monitor the patient’s blood pressure and mental status. The most common transient side effects include:
- Dissociation: Feeling disconnected from oneself or one’s body (often described as feeling “out of it”). This effect is expected and usually resolves within the observation window.
- Sedation: Feeling drowsy or dizzy.
- Nausea and Headache.
The controlled clinical environment and the required observation period ensure that these effects are managed safely. The crucial role of the provider is to not only administer the drug but also to offer a calming, therapeutic presence during the dissociative period.
Ultimately, esketamine is part of a comprehensive strategy. Its primary function is to provide a rapid “jump start” to neuroplasticity, which is then maintained and built upon by the accompanying oral antidepressant and ongoing psychotherapy. This holistic approach offers renewed hope for those struggling with the chronicity of TRD.
At light-tunnel Behavioral Health Services, our goal is to bring you cutting edge and safe treatments, inquire within.