Spravato for Treatment-Resistant Depression: Efficacy and Sexual Side Effect Profile.
Neuropsychiatric disease and treatment January 1, 2025 Ahmed Asad Raza, Ghazi Uddin Ahmed, Habiba Zafar et al. 6 citations
Intranasal esketamine (Spravato) rapidly relieves depression symptoms—often within hours—and improves remission and response rates in treatment-resistant depression (TRD) and severe major depressive disorder. Unlike conventional antidepressants, it works by blocking NMDA receptors to promote synaptogenesis and neuroplasticity. Its use is associated with a very low incidence of treatment-emergent sexual dysfunction (less than 1% of patients), a common side effect of SSRIs and SNRIs. However, esketamine can cause dissociative symptoms and blood pressure changes, and its administration requires in-clinic monitoring under a REMS program. Despite these limitations, it offers a valuable option for patients who do not respond to standard therapies.