Who Should — and Shouldn't — Consider Esketamine Therapy

Esketamine therapy, a treatment once reserved solely for anesthesia, has promising benefits for people grappling with treatment-resistant mental health conditions.

At Holistic Behavioral & TMS Therapy in Aurora and Chicago, Illinois, and Las Vegas, Nevada,  our specialists, led by Babatunde Ogundipe, MD, offer esketamine therapy to those seeking alternatives to traditional psychiatric treatments. But while esketamine offers a breakthrough for some, it is not suitable for everyone.

If you or someone you know is considering esketamine therapy, it’s important to understand who is an ideal candidate and who should exercise caution.

What is esketamine therapy?

In esketamine therapy, we administer a low dose of this FDA-approved anesthetic to relieve mental health symptoms in conditions like treatment-resistant depression, post-traumatic stress disorder (PTSD), and bipolar disorder.

EsKetamine alters your brain’s communication pathways and encourages new neural connections. The treatment quickly relieves depressive symptoms, often within hours or days, compared to the weeks it takes for traditional antidepressants to show results.

At Holistic Behavioral & TMS Therapy, we offer esketamine therapy in the form of esketamine, also known as Spravato®, a nasal spray you take under our medical supervision.

Despite its potential benefits,esketamine therapy isn’t right for everyone. We consider all aspects of your health, including mental health history, physical health, and past treatment responses.

Who should consider esketamine therapy?

Esketamine therapy can be life-changing for the right candidates. We consider you a good candidate if you:

1. Have treatment-resistant depression

If you’ve tried multiple antidepressants or psychotherapy with little to no relief, esketamine may be a viable option.

2. Think about suicide

Esketamine can rapidly reduce suicidal thoughts, so it’s often a lifesaver for those in acute crises.

3. Have PTSD

Esketamine’s unique effects on brain chemistry can help alleviate intrusive memories and emotional distress and provide relief where other treatments have failed.

4. Need quick symptom relief

Unlike traditional antidepressants, which can take weeks to show results, ketamine delivers fast symptom relief.

Who shouldn’t consider esketamine therapy?

While esketamine therapy holds significant promise, it’s not without its risks. You’re not an ideal candidate for the treatment if you:

1. Have a history of psychosis

Patients with active or past psychosis should avoid esketamine therapy because it may exacerbate their symptoms.

2. Struggle with active substance abuse

Esketamine is a Schedule III controlled substance with a potential for misuse. Patients with a history of substance abuse or addiction should not pursue esketamine therapy unless their substance use is under control.

3. Are pregnant 

Research on the effects of esketamine during pregnancy is limited, so we don’t administer esketamine to pregnant women.

4. Have uncontrolled hypertension or cardiovascular disease

Esketamine can elevate blood pressure and heart rate, posing risks for people with unstable cardiovascular conditions.

5. Have increased intracranial pressure

Certain physical health conditions, such as raised intracranial pressure, make esketamine therapy unsafe.

6. Have a prior negative response to esketamine

If you have previously tried esketamine therapy with adverse effects or no apparent improvement, further treatment may not be beneficial.

Is esketamine therapy right for you?

Before pursuing esketamine therapy, consider all the pros and cons. Our Holistic Behavioral & TMS Therapy team assesses all the pertinent factors and helps you determine the right treatment. 

If you choose to undergo esketamine therapy, we monitor you closely during and after treatment to manage potential side effects such as dizziness, nausea, or dissociation. You will also need a reliable support system, as you can’t drive immediately after treatment sessions.

If you believe you might benefit from esketamine therapy, call Holistic Behavioral & TMS Therapy or schedule an appointment online. We can provide the guidance and treatment plan you need to make an informed decision about your mental healthcare.