March 19, 2019
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VA to offer esketamine nasal spray for depression

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The U.S. Department of Veterans Affairs announced today that the newly FDA-approved esketamine nasal spray will be available to veterans with treatment-resistant depression.

“We’re pleased to be able to expand options for Veterans with depression who have not responded to other treatments,” VA Secretary Robert Wilkie, said in a press release. “It reflects our commitment to seek new ways to provide the best health care available for our nation’s Veterans.”

Image of veteran at clinic 
Source: Adobe Stock

Treatment eligibility for esketamine nasal spray (Spravato, Janssen) is based on clinical assessment and individual medical needs.

Patients will self-administer the nasal spray under observation at certified medical facilities; the spray cannot be dispensed for use at home. After receiving their dose, patients will undergo monitoring for at least 2 hours for the occurrence of adverse events such as sedation; trouble with attention, judgment and thinking; abuse and misuse; worsening depression; and suicidal thoughts and behaviors, according to the release.

The FDA approved esketamine nasal spray on March 5. Due to safety concerns, the spray will only be available through a restricted distribution system under a Risk Evaluation and Mitigation Strategy (REMS).