The incidence of suicide is on the rise, and some have even termed it a public health crisis. On March 5 the Food and Drug Administration approved a new nasal spray medication for treatment resistant depression. The nasal spray, Spravato (esketamine) is a form of the well-known and widely used anesthetic ketamine. Ketamine was found to be an effective antidepressant in the 1990’s when researchers at Yale discovered these effects. These findings were confirmed by researchers who published their finding in the Journal of American Medical Association in 2006.
The new formulation must be administered in a doctor’s office with the patient under strict monitoring. A traditional oral anti-depressive medication like Paxil must also be used. The anticipated benefit of the new formulation is the speed with which it works. Unlike traditional oral antidepressants which can take a month before effects are felt, the nasal spray formulation appears to work in a little as four hours. This new formulation offers hope to those patients whose depression cannot be effectively treated with traditional medications. It is somewhat unbelievable that this is the first new medication for the treatment of depression to be formulated in the last 30 years.
As I write this I reflect on the experience of a colleague of mine whose wife took her own life recently. I didn’t know her well, but my colleague and I had spent significant professional time together, and he never once mentioned that his wife suffered from depression. It was only until after her death that he spoke about his wife’s struggles.
We must do more to bring this crisis out of the dark and into the light. There are numerous organizations that support those who have suicidal thoughts and depression, as well as supporting their families and support systems. One such organization is the Suicide Prevention Lifeline. Their website offers information about what we all can do to help prevent suicide, including a listing of risk factors and warning signs of suicide. Additional resources can be found at the American Foundation for the Prevention of Suicide and the Suicide Prevention Resource Center.
Philadelphia also has resources:
American Foundation for the Prevention of Suicide Philadelphia Chapter: https://afsp.org/chapter/afsp-greater-philadelphia/
The Philadelphia Suicide Prevention Task Force: https://dbhids.org/P-SPTF