Description

Breaking Down S-Isomer Ketamine

S-Isomer Ketamine is a chiral compound consisting of two isomers.“Isomers” are molecules with the same chemical formula and the term “chiral” comes from the Ancient Greek word for hand.

Like your hands, the isomers are mirror images of each other. There is a right-handed version of ketamine and a left-handed version of ketamine. These are S-ketamine and R-ketamine, also known as esketamine and arketamine, respectively. When we hear of ketamine without qualifiers, this usually refers to an equal mixture of both isomers.

What’s the Difference?

S-Isomer Ketamine and arketamine affect the brain in different ways. Arketamine has shown more marked and longer-lasting antidepressant-like effects. Someone taking esketamine is more likely to experience dissociative effects. This could include ego-disintegration and hallucinatory phenomena.

Ego dissolution can be a very good thing, but it is natural to wonder why esketamine has received FDA approval for treating depression while its mirror image, a more powerful antidepressant has not.

How to Qualify for SPRAVAT (esketamine)

To qualify for treatment with SPRAVATO(esketamine), you need to have been diagnosed with TRD. If you’ve previously tried at least two oral antidepressants and haven’t seen at least a 50% improvement in your mood or symptoms after six weeks, you might consider talking with your doctor about starting treatment with SPRAVATO™.

How Often Do You Take Esketamine?

The medication is effective in its alleviation of depressive symptoms, but the potential to abuse  (esketamine) exists. For now, the drug is only available under a Risk Evaluation and Mitigation Strategy (REMS) and only at certified treatment centers. A REMS protects the patient during treatment. Components of the REMS include:

• Enrolling patients in a registry.
• Providing patients with a guide that outlines the side effects and risks of the medication.
• Administering the medication in a supervised setting.

The initial treatment with usually lasts for eight weeks. During the first four weeks, a patient visits the treatment center twice a week. During weeks five through eight, a patient visits once a week. After the eight-week mark, a patient might visit once or twice a week, based on their treatment provider’s recommendation.

At each appointment, the patient self-administers SPRAVATO™ using a nasal spray device. The nasal spray device contains 28 milligrams. Depending on their treatment provider’s recommendation, a patient will use two or three devices at each treatment.

The treatment provider will show the patient how to use the nasal spray. After the patient has performed the treatment, they will remain at the treatment center for at least two hours. During that time, the provider will monitor them for dissociation or sedation. Then, the provider will let the patient know when they can return home. Since SPRAVATO™ can cause sedation, an individual taking this medication must make arrangements to get home from the treatment center — they can’t drive themselves.

Side Effects of  (esketamine)

S-Isomer Ketaminecan cause some side effects, the most common of which are sedation and disassociation. These symptoms can cause a patient to feel disconnected from their thoughts or feelings. Other possible symptoms include nausea and vomiting, reduced sensitivity and increased blood pressure. People with high blood pressure might have a higher risk of experiencing adverse cardiovascular events while taking esketamine.

What Is IV Ketamine?

The intravenous form of ketamine contains R-ketamine and S-ketamine. It was first used in clinical practice during the 1960s as an anesthetic. Ketamine can be superior to other types of anesthesia, as it doesn’t interfere with a patient’s cardiorespiratory systems. It’s often the preferred anesthetic when treating children and can be safely used in patients as young as three months.

When administered intravenously, ketamine is 100% bioavailable, meaning all of it is effectively absorbed by the body. Other methods of delivering racemic ketamine are available, including intramuscular injection, intranasal — such as a spray — and oral. When the medication is used as an anesthetic, a non-IV form might be necessary if a patient is resistant or uncooperative.

In addition to its prevalent use in medical settings as an anesthetic, ketamine has a reputation for being a “party drug.” The drug became popular at raves and clubs in the 1990s because it can cause a person to disassociate from their surroundings. Ketamine can also cause hallucinations when used recreationally. Because ketamine can cause amnesia of events that occur when a person is under the influence, it has been used as a drug to facilitate sexual assault.

It’s important to note that the doses of ketamine used to create an anesthetic effect and to facilitate recreational use are much higher than the quantities employed when IV ketamine is given to treat TRD. Receiving ketamine in a clinical format ensures a patient will get a lower amount of the drug that does not produce dissociative symptoms