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FDA · Final action

FDA approves Spravato as a standalone (monotherapy) treatment for treatment-resistant depression

The FDA approved esketamine nasal spray for use without a concurrent oral antidepressant in adults with treatment-resistant depression. REMS certification and in-clinic monitoring requirements continue to apply.

Written by: Ira ZootMedical review status: Pending clinical reviewLast updated: August 24, 2026Evidence: Primary government source

Record details

Agency
FDA
Jurisdiction
United States (federal)
Status
Final action
Published
January 21, 2025
Effective
January 21, 2025
Expires
Not applicable / not verified
Last checked
August 24, 2026

Why it matters

Patients who cannot tolerate oral antidepressants gained a labeled pathway. Monitoring, certification, and setting requirements did not change.

Primary source

FDA — Spravato approval history and labeling (Drugs@FDA)

Not legal advice
Regulatory information is educational and may change. Verify current requirements with the appropriate agency or qualified counsel. Ketalux does not provide legal advice.

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About the author

Founder and publisher of Ketalux, based in Chicago, Illinois. Ketalux.com is owned and operated by iDigits LLC. Ira commissions and edits the site's articles and believes ketamine therapy — used responsibly — offers real hope for people living with depression, anxiety, PTSD, and chronic pain. Contact: ira@idigits.com.

Educational use only. The content on this page is provided for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Ketamine and related therapies carry risks and are appropriate only under qualified medical supervision. Always consult a licensed healthcare professional about your individual situation. Information may change as research evolves.