Esketamine could soon be approved for depression, prompting ‘excitement and hesitation’

The Food and Drug Administration is expected to decide in the coming weeks whether to approve esketamine, which would become the first major depression treatment to hit the market in decades. The psychiatry field is buzzing with excitement — and hesitation.

Esketamine — developed by Johnson & Johnson and delivered as a nasal spray — would be used in combination with oral antidepressants in patients with depression that haven’t responded to other drugs.

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But some experts aren’t convinced that there’s enough data just yet to show that esketamine is effective. And they say they want more details on how the drug should be used in the long run.

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[Professor of pharmacy and psychiatry Julie Zito] said that if the drug is approved, she would want to see providers, patients, and the families of patients work together to keep tabs on possible side effects and how well the drug is working.

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“The danger is having it so positively portrayed,” [psychiatrist Gerard] Sanacora said. “I’ve been around enough to know this is not necessarily a condition that responds to miracle drugs.”

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