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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.

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  • I’m undergoing the IV treatment (had 4 infusions) and so far I’m ecstatic with the results. This could be a godsend for people like me who suffer from crippling depression that therapy only alleviates slightly and conventional meds have no effect at all.

    The price for this version of it though? Disgraceful. The time and cost commitment just for the IVs is significant enough to be a huge obstacle for most people, one that many will not be able to overcome. My doctor currently only charges me for his time. I don’t understand how this kind of markup is legal. This drug has been around for decades. How can they justify this?

    I’ll think I’ll be sticking with the needle. Thanks for nothing, Janssen.

    • The mentioned estimated pricing of $590 and $885 is for 56 mg. or 84 mg. of the drug at wholesale. Veterinary ketamine is $9 for 1000 mg.

      Assuming twice the potency for esketamine (best case scenario), this is over a 500fold markup over the price one would pay for racemic version (based on the price your veterinary would pay) just because they patented the enantiomer.

  • All psychiatric drugs start with a great deal of excitement. Whether it is treatment resistant depression or normal depression – understanding life issues one is facing, and improving one’s coping skills etc., is what would ultimately alleviate depression.

    For me, mindfulness practices have been incredibly helpful.
    I would never resort to taking psychiatric drugs that simply result in ’emotional blunting,’ and also has mostly unknown long-term adverse effects.

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