Amphetamine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Drug reference
esketamine
Drug monograph
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
- AmphetamineSevereDatabaseDDInter
- ArmodafinilSevereDatabaseDDInter
- AtomoxetineSevereDatabaseDDInter
- BenzphetamineSevereDatabaseDDInter
Mechanism
Esketamine, the S enantiomer of ketamine, acts as an NMDA receptor antagonist.
Indications
drug-resistant depressiontreatment-resistant depression
Pharmacokinetics
Peak effect
20-40 minutes (Cmax after intranasal administration)
Half-life
7-12 hours
Bioavailability
approximately 50% (intranasal)
Protein binding
longer dosage interval than predicted from t1/2 due to slow off-rate from binding site (see Figure 16-9 in textbook, not provided in prompt). The text describes this as a noncompetitive antagonist with a very slow off-rate from its allosteric binding site on the NMDA receptor, leading to a much longer dosage interval than predicted from its terminal plasma half-life.…
Contraindications
- Potential for addiction (requires direct supervision)
Side effects
Common
sedationsleep disruptionmemory impairmentconcentration impairmentblood pressure increase
Serious
- abuse potential
Drug interactions
Armodafinil
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Atomoxetine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Benzphetamine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Caffeine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Dexmethylphenidate
Severe
Database
Clinical effect not specified
Source: DDInter
Dextropropoxyphene
Severe
Database
Clinical effect not specified
Source: DDInter
Diethylpropion
Severe
Database
Clinical effect not specified
Source: DDInter
Doxapram
Severe
Database
Clinical effect not specified
Source: DDInter
Fenfluramine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Isocarboxazid
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Levacetylmethadol
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Other Unclassified drugs
Ask House about esketamine
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Sources: Goodman & Gilman 14e·Verified: 2026-05-13 · House clinical team