Esketamine is a fast-acting treatment option for adults with treatment-resistant depression, approved by the Australian Therapeutic Goods Administration (TGA). Delivered via a nasal spray known as Spravato, it’s designed to work differently from standard antidepressants, offering relief for those who haven’t responded to other therapies.
While this medication can be life-changing for many, it’s important to understand the potential esketamine side effects before starting treatment. In this blog, we’ll explore what you might experience during and after treatment, how side effects are monitored, and what current Australian research says about its safety. Our goal is to help you make informed decisions about your mental health with confidence and clarity.
How Esketamine Works and Why It’s Used
Esketamine was approved for use in Australia in 2021 as an option for adults with treatment-resistant depression who have not responded to at least two other forms of antidepressant therapy. Its approval followed several global clinical trials, including studies submitted to the Australian Therapeutic Goods Administration (TGA), which demonstrated statistically significant improvements in depressive symptoms when used alongside oral antidepressants. Unlike traditional antidepressants that may take weeks to show results, esketamine has a faster onset of action, often providing relief within hours or days.
Common Esketamine Side Effects
Most patients tolerate esketamine well, but some side effects are relatively common. These usually occur shortly after administration and wear off within a few hours. Common esketamine side effectsinclude:
- Dizziness or vertigo
- Nausea or vomiting
- Temporary increases in blood pressure
- Disorientation or dissociation
- Drowsiness or fatigue
These Spravato side effects typically begin within 40 minutes of administration and are closely monitored during each treatment session. Patients receive their dose of Spravato nasal spray in a clinical setting and remain under observation for at least two hours.
Mild cognitive changes such as trouble concentrating or feeling “spaced out” are also reported. These experiences are generally short-lived and improve with subsequent treatments as the body adjusts. According to emerging clinical feedback, most Spravato side effects tend to diminish in intensity over time as the patient builds tolerance.
Esketamine Nasal Spray Side Effects vs Other Treatments
When compared to standard oral antidepressants, the esketamine nasal spray side effects present differently. Oral medications can cause ongoing issues like weight gain, sexual dysfunction, or gastrointestinal upset. In contrast, the esketamine nasal spray side effects are mostly short-term and occur only around the time of dosing.
Because esketamine is delivered as a nasal spray, it bypasses the digestive system, reducing gastrointestinal side effects. However, the trade-off is the need for in-clinic supervision and the potential for acute dissociative symptoms. This makes it essential to weigh up the benefits and risks of treatment-resistant depression therapy on a case-by-case basis.
Some patients may also consider non-drug alternatives like transcranial magnetic stimulation (TMS). If you’re comparing TMS vs esketamine, it’s important to consult with your psychiatrist to understand which option best aligns with your symptoms, medical history, and treatment goals.
Esketamine for Depression Side Effects: What to Expect During and After Treatment
The first few sessions are where esketamine for depression side effects are most noticeable. Patients often describe sensations of floating, blurred vision, or a dreamlike state. These symptoms usually peak within the first hour and then gradually wear off.
Because of its dissociative properties, patients are advised not to drive or operate machinery on treatment days. Some may feel tired or slightly disoriented for several hours post-treatment. However, most side effects fade by the following day, and patients can resume normal activities with little interruption.
Our team at Mind Oasis closely monitors each patient during and after administration to ensure safety and comfort throughout the process.
Esketamine Long-Term Side Effects: What We Know So Far
Research on the esketamine long-term side effects is still evolving. While the medication has shown strong short-term benefits, studies into its sustained use are ongoing. Early findings suggest that long-term use does not lead to organ damage or cognitive decline in most patients, but risks must still be managed carefully.
Concerns have been raised around the potential for misuse, particularly in individuals with a history of substance use disorder. However, when esketamine is administered in a clinical setting with proper oversight, this risk remains low.
According to a 2024 study, long-term esketamine treatment led to sustained symptom improvement in many patients, with side effects diminishing over time. Still, more data is needed to fully understand the impact of extended treatment courses and the esketamine long-term side effects.
Monitoring and Support at Mind Oasis Clinic
At Mind Oasis, patient safety is our highest priority. Every esketamine session takes place in a calm, controlled environment under the supervision of an experienced psychiatrist. We monitor your vital signs throughout the appointment and provide follow-up care to track your response and address any ongoing symptoms.
We also offer second opinions, progress reviews, and access to broader mental health services if you’re considering alternatives to esketamine, such as transcranial magnetic stimulation therapy.
While esketamine treatment is only available in person at our Sydney clinic, we provide telehealth psychiatry services in Sydney, Melbourne, Brisbane, Adelaide, and Canberra. Our nationwide network allows you to access expert care no matter where you live.
For details on pricing, visit our page on esketamine cost or contact our team for a consultation.
Book a Consultation
Esketamine is a powerful option for those living with treatment-resistant depression, but like all psychiatric therapies, it requires informed decision-making. If you’re curious about the process, potential benefits, and how to manage esketamine for depression side effects, our team is here to support you.
Book an assessment with one of our specialists today to find out whether esketamine is a suitable next step for your care plan.