So, it's just enantiomerically pure S-ketamine - not really a new drug discovery. The drug is already around as an anesthetic but it is almost finished with the FDA's approval process for treatment-resistant depression. When used as an anesthetic it is administered intravenously, but the anti-depressant formulation is a nasal spray. Cool! That definitely makes it more accessible.
I wonder if J&J got a patent on S-ketamine? The patent system is often abused this way. First you sell the racemic mixture, then when that patent is about to expire, you start selling a new product that is just the active enantiomer. And you can tell customers that it's new and improved: that you only need to take half as much! See Prilosec/Nexium, Celexa/Lexapro, etc.
Although, maybe it's difficult to manufacture just the one enantiomer, at scale?
Sweet, I like that J&J is using S-ketamine then. I think the dissociative effects of ketamine are fantastic and beneficial, even though they can be surprising. At a low dose it likely won't be an issue.
Personally, I have no issues with the dissociative effects per se. However, studies have determined that they aren't related to the antidepressant effect. Fwiw, a full clinical dose feels like ~1/4 of a 'rail'. There's no introspective trip here, just slight drunkenness.
(Incidentally, we have some evidence that the metabolite that causes the effect can be blocked via concurrent CBD administration - without reducing the dissociative effect)
The standing appointment to get slightly high for a couple of hours every three days does get inconvenient (though it's not as problematic as the resultant insomnia). I expect esketamine will be more so, for less antidepressant effect. And, being a controlled substance, I'm concerned I'll be unable to increase my dosage to make up the difference.
People seem to still be arguing about that - [1] and [2] argue that they're directly correlated in ketamine treatment, and I can't begin to guess what research on {ar,es}ketamine and metabolite efficacy is going to produce when one of these becomes readily available.
I wonder if J&J got a patent on S-ketamine? The patent system is often abused this way. First you sell the racemic mixture, then when that patent is about to expire, you start selling a new product that is just the active enantiomer. And you can tell customers that it's new and improved: that you only need to take half as much! See Prilosec/Nexium, Celexa/Lexapro, etc.
Although, maybe it's difficult to manufacture just the one enantiomer, at scale?