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A Nasal-Spray Treatment for Depression? How Esketamine Works

September 27, 2021

The half dose of medication in his first visit had little effect, so Phillip Beloin was shocked to leave the second visit and experience a whole new world outside the doors.

“The sunshine and flowers were brighter than I’d ever seen before!” the Bristol resident said. “It left me significantly changed.”

After struggling with depression since “I was aware I was alive,” the 54-year-old had found his way to the Esketamine Treatment Center, part of the Institute of Living’s Center for Interventional Psychiatry. Experts at the Center started seeing patients as soon as the treatment that uses a nasal-spray form of the anesthesia medication ketamine earned Food and Drug Administration approval.

“Esketamine can be helpful for patients like Philip who have struggled for many years and have not responded to traditional treatments,” said Dr. Benjamin Anderson, a psychiatrist with the Esketamine Treatment Center. “It’s been a pleasure to see his improvements and be part of his recovery.”

For Beloin, treatment has addressed what he calls his “broken brain” and pushed aside the depression and negative thinking that defined his life. He struggled with constant gloominess that turned his world gray and caused him to pull away from human interaction.

“I would go to the market right after it opened to avoid people because I would get irritated with them,” he said.

Esketamine is approved for people with “treatment resistant depression” or Major Depressive Disorder (MDD) that has not responded to traditional medication treatment, Dr. Anderson noted. For Beloin, depression triggered symptoms such as brain fog, anxiety, extreme fatigue, negative thinking and suicidal thoughts. He remembers at least one attempt to kill himself.

“I have always been poor because I couldn’t keep a job,” he said. “I couldn’t afford healthcare, therefore my depression was ignored. I lost most of my friends because no one wanted to be around me with my sarcasm and negative thinking.”

Through the years, Beloin was prescribed at least 15 different antidepressants and underwent cognitive behavior therapy, which worked briefly, and emotional freedom technique (EFT), or tapping therapy, which had moderate success until the pandemic kept him home.

Home is exactly where he found the Esketamine Treatment Center, however, surfing the internet one day. He started treatment in July.

“The brain fog lifted and it improved my concentration so I can enjoy things that were important to me like reading, writing and gaming,” said Beloin, who published two books but never approached a publisher on his third because he knew he’d have to do book signings and interviews.

Dr. Anderson said patients like Beloin come for two appointments a week for four weeks, then weekly for four more weeks. After that, the treatments can be given every other week. Side effects can include dizziness, nausea, sleepiness, but these are usually mild and most usually resolve in an hour or two, Dr. Anderson said.

For more information on esketamine treatment for MDD, click here.