Esketamina

Esketamine is the S-enantiomer of ketamine and is FDA-approved for treatment-resistant depression when administered intranasally under medical supervision. It is approximately 4 times more potent at NMDA receptors than the R-enantiomer and approximately 2 times more potent than racemic ketamine. Side effects include dissociation, dizziness, sedation, increased blood pressure, and nausea. Contraindicated in individuals with aneurysmal vascular disease, uncontrolled hypertension, or history of psychosis. Available only through REMS program (Spravato REMS) in the US.

Also known as: Spravato, Ketanest s, L-ketamine

Classification

Chemical: Arylcyclohexylamine
Chemical: Medicine
Psychoactive: Dissociative
Tag: Antidepressant
Tag: Hallucinogen
Tag: Pharmaceutical

Effects

Pain Relief
Sedation
Analgesia
Physical Disconnection
Increased Blood Pressure
Nausea
Dissociation
Depersonalization
Derealization
Cognitive Euphoria
Motor Control Loss
Time Distortion
Visual Distortion
Spatial Disorientation
Visual Disconnection
Open Eye Visuals
Auditory Warping
Warping

Routes of Administration

Intranasal

Dosage

Threshold: ~7 mg
Light: 7-14 mg
Common: 28-56 mg
Strong: 56-84 mg
Heavy: 84 mg

Duration

Onset: 0.08-0.25 h
Comeup: 0.08-0.25 h
Peak: 0.33-1 h
Offset: 1-2 h
After Effects: 2-24 h

Intravenous

Dosage

Threshold: 0.1 mg/kg
Light: 0.1-0.25 mg/kg
Common: 0.25-0.5 mg/kg
Strong: 0.5–0.8 mg/kg
Heavy: >0.8–1 mg/kg (anesthetic-range effects possible)

Duration

Onset: 0.02-0.08 h
Comeup: 0.03-0.08 h
Peak: 0.17-0.5 h
Offset: 0.75-1.5 h
After Effects: 120-1440 h
Total Duration: 45-90 h

Intramuscular

Dosage

Threshold: 0.15 mg/kg
Light: 0.15–0.3 mg/kg
Common: 0.3–0.5 mg/kg
Strong: 0.5–0.75 mg/kg
Heavy: >0.75–1 mg/kg (anesthetic-range effects possible)

Duration

Onset: 0.03-0.17 h
Comeup: 0.08-0.25 h
Peak: 0.5-1 h
Offset: 1-2 h
After Effects: 2-24 h

Insufflated

Dosage

Heavy: Not recommended; risks escalate sharply mg
Light: 28–56 mg
Common: 56–84 mg (labelled max per session)
Strong: ≥84 mg (above label not recommended)
Threshold: 28 mg (1 device)

Duration

Onset: 5-15 h
Peak: 20-60 h
Offset: 60-120 h
After Effects: 120-1440 h
Total Duration: 60-120 h

Harm Reduction

Check interactions before mixing substances, pay attention to dose spacing and hydration, and treat all dosage guidance as approximate rather than guaranteed safe.

Sources

Substance data is aggregated from the following public harm-reduction and reference sources.

dose.wiki

Links

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