On January 27, the official website of the Drug Evaluation Center (CDE) of the State Food and Drug Administration of China announced that Janssen Company has submitted an application for the listing of the 5.1 new drug escramidone hydrochloride nasal spray and has been accepted. According to public information, this is the Pravato (esketamine) nasal spray developed by Janssen, which has been approved for marketing in the United States in 2019, and is the first antidepressant approved by the FDA with a new mechanism of action in 30 years, representing a major breakthrough in the treatment of depression.
According to the World Health Organization (WHO), about 5% of adults worldwide suffer from depression, and more than 300 million people suffer from the disease. Some people with depression still do not improve their symptoms after receiving a variety of antidepressants. The esketamine nasal spray developed by Janssen is an S-mirror isomer of ketamine. Ketamine is generally used as an anesthetic in medical clinics. However, the researchers also found that ketamine can relieve depressive symptoms within a few hours of administration, while antidepressants usually take several weeks to take effect.
From the perspective of mechanism of action, esketamine nasal spray is a non-selective, non-competitive NMDA receptor antagonist. It can specifically modulate NMDA receptors, potentially helping to repair neural connections in brain cells in people with depression. Since existing depression therapies mostly act on serotonin signaling networks, esketamine represents an innovative mechanism of action.
