Ellen Talmage says a ketamine-derived nasal spray has changed her life after decades of failed treatments.
Talmage, 66, of Baiting Hollow, New York, is among roughly 40 patients enrolled in an esketamine program at Mather Hospital in Port Jefferson, where doctors administer the FDA-approved drug Spravato to people with severe, treatment-resistant depression. Some 62% of participants have reported symptom improvements since starting the multiweek protocol.
“I’m so much better that after this [interview], I’m picking up my daughter-in-law and the two grandbabies, and we’re going to the ocean,” Talmage said. The outing marks a dramatic shift for the once-reclusive woman, who previously needed anxiety medication just to visit a grocery store and would often break down crying during errands.
“I booked tickets once to a really expensive concert for my birthday, and I couldn’t go – that was just part of the deal… anybody who’s had it for that long, you miss out on a lot of Christmases,” she said.
The program begins with a low dose of 56 milligrams, administered in person twice weekly, with amounts gradually increased as patients respond. Users remain under observation for two hours after each session, seated in comfortable chairs with television and music, while staff monitor for safety concerns.
Talmage likened the experience to riding Space Mountain. “That’s the best way I can kind of describe it – because it’s definitely colors and whatever,” she said.
While conventional antidepressants target serotonin and norepinephrine, Spravato works through a different mechanism, hitting NMDA receptors at the cellular level to alter mood. Dr. Erin Dainer, Mather Hospital’s psychiatry chair, said the transformation she witnesses exceeds what other treatments achieve.
“From going to not being able to get out of bed and dress yourself to thinking about the future and having a job and having a purpose and meaning in life,” Dainer said. “I don’t see that with other treatments the way I do with this.”
Mather inpatient psychiatrist Paniz Johari predicted esketamine will play a seismically shifting role in managing treatment-resistant depression within the next decade. “I think that’s hard to say, but at the rate we’re going, it’s looking like that to me,” she said.
The medical staff is also confronting public confusion between the regulated therapy and street ketamine, sometimes called “Special K.” Actor Matthew Perry fatally overdosed on the illicit version last year.
“Matthew Perry absolutely should never have happened,” Dainer said. “That’s why we have so many regulations with this medication because we want to ensure safety; we want to ensure efficacy.”
Another patient, who requested anonymity, credited the treatments with giving him the courage to pursue becoming a peer-to-peer counselor to help others who are suffering. “I think it’s a big thing between the ketamine and helping other people, that it gives you a purpose,” he said.