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Viewpoint: Esketamine promises to boost depression treatments—but we don’t know enough about long-term effects

| | March 29, 2019

With great fanfare, a new antidepressant entered the U.S. market in March [2019], the first fundamentally new medicine for depression in decades. Based on the anesthetic ketamine, the drug — called Spravato — is intended to help people with severe depression quickly, taking effect within hours or days instead of the weeks that typical antidepressants take. But for all the hubbub, big questions have gone unanswered about the drug.

Some psychiatrists are concerned that the drug was approved by the U.S. Food and Drug Administration based on skimpy data, under standards that were less rigorous than those required for previous antidepressants. It remains unclear, for example, what happens as someone stops taking the drug, as well as whether it has long-term effects.

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MRI scans of people who have abused ketamine for a long time reveal brain damage (though other factors could be sources of that damage). And studies on animals show ketamine-induced brain damage, too. But not much is known about esketamine’s long-term effects in people taking it for severe depression. “If you take ketamine for too long — and it’s unclear what too long is — that’s going to be a problem,” [psychiatrist Dan] Iosifescu says.

Read full, original post: A new ketamine-based antidepressant raises hope — and questions

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