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Clinicians embracing new depression drug esketamine with ‘enthusiastic caution’

Who can provide the new depression drug esketamine? And will it be available at “ketamine clinics”? STAT looks at five key questions.

Patients with major depression who haven’t responded to other treatments will soon have a new option: esketamine, a rapid-acting therapy derived from the long-used anesthetic ketamine.

But the drug’s approval on Tuesday sparked a string of new questions, from how much patients will have to shell out for the drug to how clinicians will be able to accommodate patients who need to be monitored for two hours after every dose.

“This is an extraordinarily exciting time,” said Dr. Robert Meisner, a psychiatrist and the medical director of the Ketamine Service at McLean Hospital in Belmont, Mass. “That said, it’s important to proceed with enthusiastic caution.”

Here’s a look at five key questions as the drug, which will be sold

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