Can Esketamine help me with my persistent low mood?

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

I understand it is frustrating when first-line treatments do not provide the relief you need.

1. Combination therapy

• Pros: This is a common and often effective strategy. Adding a second medication, such as Bupropion (an antidepressant that increases energy and motivation) or a low-dose antipsychotic such as Aripiprazole (used to enhance antidepressant effects), can boost the benefit of your SSRI and better target symptoms like fatigue and low motivation.

• Cons: It involves taking more than one medication, which may increase the risk of side effects or drug interactions. It requires careful monitoring by your doctor.

• Monitoring: Your symptoms are followed closely, often using a simple mood questionnaire, and any new side effects are checked during regular follow-up visits.

2. Esketamine (Spravato)

• Pros: This is a newer and powerful option for treatment-resistant depression (when other medications have not worked). It can work much faster than oral medications, sometimes within hours or days.

• Cons: It is given as a nasal spray under medical supervision in a clinic (usually twice a week at the start). Side effects can include dissociation (feeling detached from your body or surroundings, like being in a dream), dizziness, and increased blood pressure during treatment. It is also more expensive and requires strict safety protocols.

• Monitoring: Effectiveness is measured with mood assessments. Safety is checked by monitoring your blood pressure before and after each session, and you are observed until stable before leaving the clinic.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.