The New Hit Depression Treatment? A Ketamine-Derived Nasal Spray
Podcast: The Journal
Hosts: Kate Linebaugh, Ryan Knutson, and Jessica Mendoza
Release Date: March 21, 2025
Introduction
In this episode of The Journal, hosted by Jessica Mendoza, the discussion centers around a groundbreaking treatment for depression: Spravato, a ketamine-derived nasal spray developed by Johnson & Johnson (J&J). The episode delves into the personal journey of Sean Furey, a writer battling treatment-resistant depression, and explores the scientific and commercial aspects of Spravato's rise in the pharmaceutical industry.
Sean Furey's Story
[00:18] Sean Furey, a 36-year-old writer from Fort Worth, Texas, shares his lifelong struggle with depression, anxiety, and PTSD. His passion for horror films is not just a hobby but a therapeutic outlet. Furey is currently working on a vampire thriller, a metaphorical exploration of how his depression "sucks the life out of his family and wife."
Notable Quote:
"Sometimes I feel like I'm sucking the life out of my family. So I decided to make that literal and explore it through a vampire film." — Sean Furey [00:48]
The Challenge of Treating Depression
Depression affects nearly 30% of adults in the U.S., yet treatment options have remained largely unchanged for decades. Traditional antidepressants, such as SSRIs like Prozac and Zoloft, increase serotonin levels but often take four to six weeks to show effects. Moreover, many patients, including Furey, experience treatment-resistant depression, where these medications fail to provide relief.
Expert Insight:
Dr. Hossaini Manji, a neuroscientist and professor of psychiatry at Oxford University, highlights the complexity of treating mental illnesses compared to physical ailments. He emphasizes the need for treatments that not only adjust neurotransmitter levels but also promote the creation of new brain connections.
Notable Quote:
"Almost all our existing antidepressants take about four to six weeks to work. That led many people, including myself, to think maybe we're hitting the wrong target." — Dr. Hossaini Manji [05:31]
The Development of Spravato
In pursuit of more effective treatments, Dr. Manji explored ketamine, a psychedelic known for its hallucinogenic properties and use as an illicit club drug. Recognizing its potential, Dr. Manji joined J&J in 2008 to spearhead the development of Spravato.
Notable Quote:
"Spravato is the first new type of depression treatment since Prozac was approved back in 1987." — Jessica Mendoza [10:41]
Dr. Manji and his team innovated by creating a nasal spray version of ketamine, allowing for rapid delivery to the brain and increased convenience compared to intravenous administration. This method also aimed to minimize abuse potential by using precise dosages and disposing of the device after each use.
Clinical Trials and FDA Approval
Spravato underwent rigorous clinical testing, demonstrating rapid antidepressant effects, with 70% of treatment-resistant patients responding within 24 hours. Despite initial skepticism due to ketamine's reputation, J&J secured FDA approval in 2019 for Spravato to be used alongside other antidepressants.
Notable Quote:
"Spravato is the only antidepressant to ever receive breakthrough designation from the FDA." — Dr. Hossaini Manji [16:29]
The FDA's approval marked a significant milestone, positioning Spravato as a beacon of hope for millions suffering from treatment-resistant depression.
Sean's Experience with Spravato
Encouraged by his psychiatrist, Sean Furey began Spravato treatments in 2023. His initial session was daunting, characterized by feelings of detachment and mild hallucinations. However, with his wife’s support, Furey persisted with the treatment, experiencing gradual improvements in his mood and cognitive functions.
Notable Quote:
"I could handle things better than I could before. My confidence came back to some extent. I felt like this shell had broken, and I was able to finally kind of breathe again." — Sean Furey [14:44]
Furey describes Spravato as transformative, enabling him to recognize and manage negative thoughts, thus breaking the cycle of self-abuse.
Spravato's Market Impact and Future Prospects
Since its challenging introduction, Spravato's sales have surged, surpassing a billion dollars worldwide. J&J has expanded clinic networks and launched extensive advertising campaigns, fueling Spravato's growth. With over 46,000 prescriptions in the U.S. since early 2023 and estimates that 3 to 5 million people suffer from treatment-resistant depression, J&J anticipates Spravato could generate up to $5 billion annually.
Future Directions:
The success of Spravato has opened doors for other psychedelic-based treatments. Dozens of startups are now exploring drugs like LSD and psilocybin for mental health applications. Although the FDA recently declined to approve MDMA for PTSD pending further research, the momentum from Spravato suggests a promising future for non-traditional antidepressants.
Notable Quote:
"Spravato is also the only antidepressant to ever receive breakthrough designation from the FDA. So great momentum and a long term commitment to patients suffering with depression." — Dr. Hossaini Manji [16:29]
Conclusion
Sean Furey's journey with Spravato exemplifies the potential and challenges of introducing novel treatments for mental health. While Spravato offers hope for those with limited options, questions about long-term use and safety remain. Nonetheless, its approval and commercial success signify a pivotal shift in how depression can be treated, paving the way for future innovations in psychiatric medicine.
As Furey continues to navigate his path to recovery, he channels his experiences into his filmmaking, aiming to inspire others battling similar demons.
Final Thought:
"You don't have to just sit with it. You can fight those things." — Sean Furey [19:38]
Support & Resources:
If you or someone you know is struggling with depression or suicidal thoughts, reach out to the Suicide and Crisis Lifeline by texting or dialing 988.
Summary prepared based on the transcript of "The New Hit Depression Treatment? A Ketamine-Derived Nasal Spray" from The Journal, hosted by Jessica Mendoza.