There was a recent radio show, 1A, discussing the benefits of ketamine for patients with treatment resistant depression. The show provides a patient perspective and the physician perspective. This topic is getting a lot of press at the moment because of a new FDA approved formulation called Spravato (esketamine). 
We compound a ketamine nasal spray (and have been for several years) but the newly approved medication is different than the “racemic” mixture that we compound. There is some thought in the medical community that the mixture formulation is more effective with less side effects. 
We have a number of patients with depression using ketamine nasal spray that have seen dramatic results. One patient recently told me that “since he has been using ketamine nasal spray, he wants to get out of bed each day! This is the best he has felt in 30 years!”. On the radio show, they call it transformational! And that is what we hear from patients! One of the benefits of ketamine nasal spray is that is works quickly-hours to days- instead of in months. This onset of action is very beneficial in a patient that may be suicidal. 
We are happy to discuss how to dose ketamine for depression with your prescriber. We can also give you a few names of providers if you are interested in seeing if you are right for this therapy.
If you or someone you know needs help, call the Suicide Prevention Hotline at 800-273-8255.
Jennifer Burch, PharmD, RPh, CDCES