UK – NICE knocks back J&J’s depression nasal spray Spravato

Johnson & Johnson’s depression nasal spray Spravato has been hit with a rejection by the UK’s National Institute for Health and Care Excellence, shortly after gaining approval in the EU.

Spravato (esketamine) is a glutamate NMDA receptor modulator – when it was first approved by the FDA in March last year it was quickly hailed as an end to a drought in new-mechanism antidepressants. It is a single isomer form of ketamine, but is administered at a much lower dose than the notorious illegal recreational drug.

For clinicians and patients, it has particular importance as it starts to work more rapidly than currently approved antidepressants, which can take several weeks to kick in.

It was also approved by the European Medicines Agency (EMA) at the end of last year, for use alongside conventional oral antidepressants in adults who have not responded to treatment with at least two lines of therapy – oral selective serotonin reuptake inhibitor (SSRI) or serotonin and norepinephrine reuptake inhibitor (SNRI) drugs alone…