Talk:Esketamine

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Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Esketamine.

PubMed provides review articles from the past five years (limit to free review articles)
The TRIP database provides clinical publications about evidence-based medicine.
Other potential sources include: Centre for Reviews and Dissemination and CDC

IUPAC name added

IUPAC name added 2-(2-chlorophenyl)-2-(methylamino)cyclohexanone--ChemSpiderMan (talk) 02:23, 17 December 2007 (UTC)[reply]

Criticism

What are the advantages of Esketamine over Ketamine? Is it the same kind of rebranding as with Escitalopram? AKA "take the stereoisomer and patent it = profit"? Some may speculate that it's merely a marketing ploy... --2A04:4540:7005:4800:6C08:7406:2791:2444 (talk) 22:46, 12 February 2019 (UTC)[reply]

It is very well known that different stereoisomers of many drugs have different pharmacology and pharmacodynamics, so it is not "merely a marketing ploy". An example would be Warfarin, where the (S)-isomer is mostly metabolised by CYP2C9, and the (R)-isomer by some other enzymes. However, it is not unusual for drug companies to start out by patenting the racemic mixture, and after the patent runs out - patenting one of the stereoisomers. I guess this could be seen as a kind of a marketing ploy, but it's not always the case.Adrianpip2000 (talk) 16:17, 7 March 2019 (UTC)[reply]

Adrianpip2000 is correct. The enantiomers that compose the racemate of an essentially chiral chemical compound, each individually very often have distinct pharmacologic, pharmacokinetic, and pharmaodynamic properties, and so, while historically offered first as the racemate, have become the focus, individually, in modern new drug applications to the FDA (and comparable submissions to othr approval agencies). Indeed, agencies now expect that the enantiopurity of chiral agents and its implications for agent activity will be determined and studied, given that the less active or inactive enantiomer may in fact have deleterious properties relative to the desired therapeutic outcome (see the thalidomide article). In essence, if the activity of the enantiomers are not identical (which they essentially never are), then the undesirable enantiomer is understood to simply be a contaminent of the modern drug preparation. So, is there an economic motivation? Certainly, since new approvals requires enantiopurity characterisation, and there is no profit for a failed drug application. Also, certainly, if the altered properties of the single enantiomer differ substantially from those of the racemate, allowing the case to be made for a new chemical entity with important therapeutic potential (as the FDA believes to be the case for the esketamine nasal spreay), and therefore a new period of patent protection for the drug. Pharmaceutical discovery, development, and production is, afterall a business. 2601:246:CA80:3CB5:AC8F:637A:4535:5D7C (talk) 00:49, 12 March 2019 (UTC)[reply]

Subjective Effects Section

Someone should make a subjective effects section using the sources cited in this forum post:

http://www.bluelight.ru/vb/threads/447697-Ketamine-Subthread-Isomers-R-and-S-Ketamine

I can help. — Preceding unsigned comment added by Exercisephys (talk • contribs) 16:22, 22 January 2013 (UTC)[reply]

References need for this

"Esketamine is a fast acting powerful stimulant that creates an instant "high" sensation. Esketamine is being used more and more in illegal recreational use because of the instant "altered state effect" it creates. In clinical trials, six patients who were taking the drug died, three from suicide. Esketamine creates a feeling of being temporarily "disconnected" from your body and your mind."

Doc James (talk · contribs · email) 15:43, 7 March 2019 (UTC)[reply]

Not sure why this removed

"The cost of the nasal spray as of 2019 will be 4,700 USD to 6,800 USD for the first month.^[1]"

References

^ "J&J prices ketamine-like depression treatment at $590-$885 for two..." Reuters. 6 March 2019. Retrieved 7 March 2019.

Doc James (talk · contribs · email) 15:43, 7 March 2019 (UTC)[reply]

This "rapid-acting stimulant"

Appears to be vandalism. Not in the ref. Doc James (talk · contribs · email) 15:43, 7 March 2019 (UTC)[reply]

Lede sentence removed

...because the lede sentence content regarding recreational use (a) does not appear in the main body of the article, and (b) is not sourced in the lede. It can certainly appear, with a source, but we should not violate WP:REF for such an important matter. (Per WP policy, wikilinks do not constitute a mode of referencing/sourcing of article content.) 2601:246:CA80:3CB5:AC8F:637A:4535:5D7C (talk) 00:27, 12 March 2019 (UTC)[reply]

[1] "J&J prices ketamine-like depression treatment at $590-$885 for two..." Reuters. 6 March 2019. Retrieved 7 March 2019.

[1]