Early Clinical Experiences of Esketamine Nasal Spray in the UK in Adults with Treatment-Resistant Major Depressive Disorder: Advisory Panel Recommendations

Figures & data

Box 1 Controlled Drug Register requirements

Date supplied

Name and address of person supplied

Quantity, form, and strength supplied

Details of authority to possess prescriber or license holder details

The name of the healthcare professional who collected the drug

Note: Data from Pharmaceutical Services Negotiating Committee.²²

Box 2 Pre-Appointment Criteria for Patients

Advise your patient:

Not to engage in potentially hazardous activities following their treatment with esketamine nasal spray, such as driving or operating machinery, until the day after following a restful night’s sleep To plan suitable travel arrangements following each of their appointments, ideally booking a taxi or arranging for a friend/family member to collect them, as driving is not recommended Not to eat for at least 2 hours before administration to avoid potential nausea and vomiting Not to drink liquids for at least 30 minutes before administration to avoid potential nausea and vomiting Not to use any nasally administered corticosteroids or decongestants for at least 1 hour before administration To arrange for a carer or chaperone to accompany them if considered necessary

Note: Data from Spravato® (esketamine hydrochloride).⁵

Box 3 Pre-Discharge Criteria for Patients

Before discharging the patient, ensure:
The next treatment session appointment has been scheduled and the patient supplied with a written record as a reminder
Blood pressure has returned to acceptable levels^a
Symptoms from any treatment-related adverse reactions have resolved to a point where the patient is considered clinically stable and ready to leave the healthcare setting
The patient has been reminded not to engage in potentially hazardous activities, such as driving or operating machinery, until the next day after a restful night’s sleep

Notes: ^aAs a general guide: ≤140/90 mmHg for patients <65 years of age and ≤150/90 mmHg for patients ≥65 years of age.⁵

Pharmaceutical Services Negotiating Committee. Controlled Drug regulations. Available from: https://psnc.org.uk/contract-it/pharmacy-regulation/controlled-drug-regulations. Accessed December 16, 2021.

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Spravato® (esketamine hydrochloride). Summary of product characteristics. High Wycombe, UK: Janssen-Cilag Ltd; 2021.

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