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Ketamine Versus Esketamine - What is the Difference?





Here at The Epec Clinic, our doctors provide Esketamine for the treatment or relief of anxiety, depression and or addiction. For information call us 443-559-8354

Ketamine and Esketamine are closely related compounds, but they have some differences in their chemical structure, effects, and uses. Here’s a breakdown:

Ketamine

  • Chemical Structure: Ketamine is a racemic mixture, meaning it contains equal parts of two enantiomers: R-ketamine and S-ketamine (esketamine).

  • Uses: Initially developed as an anesthetic, ketamine is also used off-label for treatment-resistant depression and other mood disorders. It can be administered intravenously, intramuscularly, or intranasally.

  • Mechanism of Action: It works primarily as an NMDA receptor antagonist, which leads to increased glutamate release and can promote neuroplasticity. Its rapid antidepressant effects are thought to be due to these mechanisms.

  • Side Effects: Common side effects include dissociation, hallucinations, increased blood pressure, and potential for abuse.

Esketamine

  • Chemical Structure: Esketamine is the S-enantiomer of ketamine, making it more potent in some of its effects compared to the racemic mixture.

  • Uses: Esketamine is FDA-approved for treatment-resistant depression and is available as a nasal spray (Spravato). It’s used in conjunction with an oral antidepressant.

  • Mechanism of Action: Similar to ketamine, esketamine also acts as an NMDA receptor antagonist but may have a faster onset of action and a different safety profile.

  • Side Effects: While it shares many side effects with ketamine, esketamine has been designed with a focus on safety and efficacy in a clinical setting. Monitoring during and after administration is often required.

Summary

  • Potency: Esketamine may be more potent than ketamine in some aspects.

  • Administration: Esketamine is primarily administered as a nasal spray, while ketamine can be given in multiple forms.

  • Approval: Esketamine has specific FDA approval for depression, whereas ketamine is often used off-label.

Both have shown promise in treating depression, but the choice between them may depend on individual patient needs, the setting of administration, and specific medical guidelines. Always consult a healthcare provider for personalized advice.

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