Esketamine Treatment

Sometimes medication and therapy cannot help with treatment-resistant depression. It might be time to try a different, more innovative approach.

Esketamine is a nasal spray approved in March 2019, by the U.S. Food and Drug Administration for use with an oral antidepressant for people with “treatment-resistant depression” or MDD that does not respond over time to different medications or treatment.


Esketamine is a form of Ketamine, a medication used as general anesthesia since the 1960s and more recently used in depression. At the Institute of Living, patients administer esketamine nasal spray under supervision of a health professional.

Treatment appointments at the Center are at least two hours long so staff can monitor patients for any side effects from the nasal spray. Treatments start twice per week for the first four weeks. In weeks five through eight, treatments are weekly. After week nine, they can be reduced to every other week. Patients will not be able to drive until the day after treatment so they need to arrange for transportation to and from all appointments. In addition, patients are advised to avoid eating 2 hours before and drinking liquids 30 minutes before treatment as some patients report nausea or vomiting.

The most common side effects from esketamine treatments include:

  • Dissociation, or feeling disconnected from yourself, your thoughts, feelings, space and time
  • Dizziness
  • Nausea and vomiting
  • Sleepiness
  • Feeling like you’re spinning
  • Anxiety
  • Lack of energy
  • Increased blood pressure
  • Feeling drunk


Talk to your psychiatric provider to see if Esketamine may be right for you. Your psychiatric provider (psychiatrist or psychiatric APRN) can make a referral by completing our online referral form.

Esketamine Referrals


In addition to providing this novel treatment, we are committed to advancing the field through research. We invite all of our patients to participate be enrolling in our research registry.

Center for Interventional Psychiatry

Esketamine Treatment