New Hope for Hard-to-Treat Depression: Ketamine Spray Subsidised

Australia to Subsidize Ketamine Nasal Spray for People With Hard-to-Treat Depression The Australian government will begin paying for a ketamine-based nasal spray to treat people with treatment-resistant depression, marking a significant advance in mental health care. The drug, which is sold under the brand name Spravato (esketamine), will be covered by the Pharmaceutical Benefits Scheme (PBS) starting in the middle of 2025, which will significantly lower the price for patients who are eligible for it. This move is being praised by psychiatrists and mental health advocates, who say it could be life-changing for thousands of Australians who have struggled for years without relief from conventional treatments.

### A Breakthrough for Treatment-Resistant Depression People who have not responded to at least two different antidepressant medications suffer from treatment-resistant depression. When traditional treatments like talk therapy, SSRIs, or changes in lifestyle don't help, this condition can make people feel hopeless. A novel approach is provided by esketamine, a ketamine derivative. Instead of targeting serotonin or dopamine like most antidepressants, it affects the brain’s glutamate system, helping to restore neural connections and improve mood much more rapidly. “This is a real breakthrough,” said Dr. Rachel Morgan, a consultant psychiatrist based in Sydney. “For patients who’ve exhausted every option and are still living with severe depression, esketamine offers hope—often within hours or days, instead of weeks.”

### The Workings of Spravato is delivered through a nasal spray and must be administered in a clinical setting under medical supervision. Patients usually begin with twice-weekly sessions, which may taper off depending on their response. After each session, patients are monitored for about two hours, as the drug can cause side effects like dissociation, dizziness, or increased blood pressure. It’s important to note that Spravato is not a standalone treatment. It's prescribed in combination with a traditional oral antidepressant and is used alongside a broader treatment plan that may include therapy and lifestyle changes.

### Cost Relief for Patients Without subsidy, Spravato treatments can cost hundreds of dollars per session—making them unaffordable for many Australians. The government’s decision to list it on the PBS will bring the price down to less than $42.50 per script for general patients and even lower for concession card holders. Mental health advocacy groups have long campaigned for the drug’s inclusion on the PBS, citing the urgent need for more effective and accessible treatments for those who don’t respond to standard care. “This is a huge win for the mental health community,” said Claire Thomson from Beyond Blue. “People who were once out of options can now access a cutting-edge treatment without being burdened by cost.”

### Addressing a Growing Mental Health Crisis The move comes at a time when mental health challenges are rising sharply in Australia. Data from the Australian Institute of Health and Welfare shows that depression rates have increased significantly over the past decade, with the COVID-19 pandemic adding even more pressure to the healthcare system. The government is taking a more cutting-edge, science-based approach to mental health treatment by supporting novel treatments like esketamine. Experts believe that it will not only enhance people's quality of life but also cut down on the long-term costs of untreated or chronic depression.

### Careful Implementation and Follow-Up Esketamine is not without controversy, despite its promise. Ketamine has a history of recreational misuse, and long-term effects of repeated medical use are still being studied. That’s why the drug is tightly regulated: all doses must be given under medical supervision in approved settings, and it is not available for take-home use. “This isn’t a quick fix,” said Dr. Morgan. “But for the right patients, with the right support, it could make all the difference.”

### A Brand-New Approach to Treatment for Depression The inclusion of Spravato on the PBS reflects a growing recognition of the complexities of mental illness and the need for innovative treatments. For Australians battling severe, unrelenting depression, this announcement brings a new option—and with it, a renewed sense of hope. As Dr. Morgan put it, “This is more than a medication—it’s a second chance.”