Ketamine, initially developed during wartime as an anesthetic, has recently gained recognition for treating depression, anxiety, and PTSD off-label. However, obtaining ketamine treatment comes with challenges. Ketamine exists as a 50:50 mixture of mirror-image compounds – esketamine and arketamine. As a generic drug, ketamine cannot be patented. Therefore, no pharmaceutical company can or will invest the time and money to gain an FDA indication for its use for anything other than anesthesia. However, esketamine the left-handed half of ketamine, was granted a patent and then approved by the FDA as a novel drug called Spravato.
Spravato is strictly regulated and limited in use. In contrast, customized ketamine therapies for depression have adapted over fifteen years to offer personalized, flexible care. Treatment with ketamine may use individualized dosages based on patient needs and response over time. Conversely, Spravato follows only rigid protocols. With flexibility to optimize care for diverse needs, customized ketamine therapies may achieve superior results to the more restrictive approved option.
Customized Ketamine Treatment Allows for Variability
Tailored plans with ketamine permit adjustment based on each patient’s needs and responses. This flexibility enables professionals to alter dosages, methods of delivery, and frequency according to unique needs. Customized regimens can be modified via nasal spray, through the skin, or orally/under the tongue. Meanwhile, esketamine exclusively uses fixed-dose nasal sprays administered under supervision within certified facilities.
Treatment with ketamine provides various options for dosing. Intravenous infusions necessitate medical settings, but nasal sprays and lozenges are simply taken at home with professional guidance. Remaining at certified clinics two hours after even a single spray complicates esketamine treatment and increases its cost.
Interestingly, ketamine itself contains 50% esketamine anyway, yet regulatory distinctions exist between them. Ketamine additionally tends to be more affordable and accessible, compared to esketamine’s high expenses unless entirely covered by insurance.
Potential for Improved Patient Outcomes
The individualized nature of personalized ketamine therapy allows clinicians to closely monitor each patient’s response and adjust treatment accordingly, ensuring the optimal dose and administration approach specific to that person. This adaptability aids in achieving enhanced therapeutic results and satisfaction for those receiving care. In contrast, the rigid protocols for esketamine (Spravato) may not suit all patients, potentially curtailing its effectiveness. Some studies seem to show that eskatamine is more potent per mg than arketamine. Yet other recent investigations indicate that arketamine within ketamine may actually have stronger antidepressant properties compared to the esketamine component. While esketamine (Spravato) is patented in the United States, a Canadian court found it does not qualify as an innovative medication when evaluated beside the original ketamine formulation.
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Conclusion
While esketamine (Spravato) provides a standardized and FDA-approved treatment option for mental health issues, customized ketamine therapy presents a more flexible and accessible alternative. By crafting individualized therapeutic plans tailored to each person’s needs, customized ketamine therapy has the capability to further enhance treatment outcomes and overall satisfaction for those receiving care.