James* has had significant depression and anxiety his entire adult life and was in 'a dark place' when he was referred to a new treatment option, esketamine.
After trying many different treatments and medications, I always seemed to relapse or push back towards a deep level of depression.
"My psychiatrist recommended this new treatment option, and I did have some concern at the start, but after further discussions with my psychiatrist and doing my own research, I felt reassured."
James visits the new Esketamine Therapy Service at Epworth Camberwell - one of only two such clinics in Victoria - to have the treatment administered each week, under the supervision of a nurse.
Epworth psychiatrist, A/Prof Ashu Gandhi, leads the esketamine program at Epworth Camberwell supported by a team of eight doctors and seven specially trained nurses.
Most patients accessing the service have been struggling with persistent depressive symptoms that have impacted their daily function and enjoyment life.
While some of us may have heard of ketamine, which is used medically as an anaesthetic agent and for pain management, esketamine differs from ketamine in its chemical structure, formulation, administration and clinical use.
"Esketamine, like ketamine, affects the NMDA receptors. It is administered as a nasal spray and provides a stronger antidepressant effect at lower doses. Treatment is carried out under strict medical supervision in approved centres," says A/Prof Gandhi.
"It is TGA approved for use in treatment resistant depression, where the patient has a major depressive disorder that has not responded to at least two different oral antidepression medications.
"Like any treatment, it is not going to be suitable or effective for every patient, but we have seen several patients who have had an inadequate response to multiple antidepressants and augmentation strategies report that they have never felt so clear headed and hopeful. It is very promising."
James, a father of two, said he has noticed a difference and so has his family.
"It has been a big load off my mind - I don't have that constant dread and concern I use to have. I'm slowly integrating myself back into life," he said.
"I have more quality time with my kids and I'm becoming less frustrated and angry at little things. I am so happy my kids have noticed a difference - they are the main reason I do everything."
Eligible patients can be referred to an authorised esketamine psychiatrist at Epworth Camberwell by a GP or their current psychiatrist.
