Depression is a mental disorder that affects more than 264 million people worldwide, involving all ages. With the ongoing pandemic, the Centers for Disease Control and Prevention (CDC) has also identified a surge of cases of depression. There are, however, depression cases, which do not respond well to traditional treatment, and doctors in the UK are now looking at ketamine nasal spray to treat them.

The National Institute for Health and Care Excellence (Nice) is looking at esketamine, which is made by Janssen and also called Spravato, to be applied as nasal spray in order to help treat severe cases of depression. In Nice's second public consultation regarding the draft guidance on the use of esketamine, they are now considering it to treat those who have not responded well to two antidepressants or more.

A news release by Nice previously on esketamine use noted that the body was not recommending it for treatment-resistant depression. It was published on BMJ in January. Some of the reasons stated by Nice back then were uncertainties over the drug's clinical and cost-effectiveness. They noted then that it was still unclear if the improvements that one will attain out of esketamine will be maintained after the patient undergoes a course of treatment. They were also asking if it will improve the quality of life of the patient. However, the recent second consultation may reverse the draft guidance that the body has with regards to esketamine and depression.

There is evidence taken from clinical trials, which strongly suggest that esketamine is more effective compared to placebo, albeit it was somehow unclear on how effective it is due to the manner by which the trials were carried out.

"There is a clear need for effective alternative treatment options for people with treatment-resistant depression," said Nice's Deputy Chief Executive and Director of the Centre for Health Technology Evaluation Meindert Boysen.

Depressed man Depressed man
CDC Says Pandemic Causes Depression And Heavy Drinking Photo: Holger Langmaier - Pixabay

In addition, he also stated that their independent committee gives due recognition to the importance of addressing mental health challenges. However, he added that if esketamine would be introduced into the NHS' clinical practice, there would be a need to change the structure and delivery of services.