Esketamine

Category: pharmacological

Aliases: Spravato

Pharmacological Mechanism

S-enantiomer of ketamine — ~4× NMDA receptor affinity vs racemate. Intranasal formulation FDA-approved for treatment-resistant depression in conjunction with oral antidepressant. Rapid (hours) antidepressant effect; REMS for dissociation + abuse risk.

Half-Life (t½)

IN: 8h

Dosing Guidelines

• IN: Typical 56 mg (Range: 28–84 mg)

Target Organ Systems

• nervous

Pathways It Modulates

• BDNF / TrkB neurotrophic signaling (activator) — TrkB-mTOR (acute)
• Glutamate receptor pharmacology (inhibitor) — NMDA channel pore (S-enantiomer of ketamine)
• Metabotropic glutamate receptors (inhibitor) — NMDA (S-enantiomer)

Chemical Identifiers

• PubChem CID: 182137
• Formula: C13H16ClNO
• Molecular weight: 237.73 g/mol
• InChIKey: YQEZLKZALYSWHR-ZDUSSCGKSA-N
• SMILES: CN[C@@]1(CCCCC1=O)C2=CC=CC=C2Cl

References

• PMID 33128208