Description
S-ketamine consists of pure S(–) ketamine, one of the two enantiomeric forms of ketamine, and is generally regarded as more potent than its R-enantiomer. This increased potency is largely due to its higher affinity for N-methyl-D-aspartate (NMDA) receptors, which play a key role in pain modulation, neuroplasticity, and mood regulation within the central nervous system. By interacting with the brain’s glutamatergic pathways, S-ketamine influences neural signaling processes that differ from those targeted by conventional antidepressant medications.
Uses:
S-ketamine is primarily used in intranasal formulations for the treatment of depression, particularly in individuals diagnosed with treatment-resistant depression (TRD). It has been approved by the U.S. Food and Drug Administration (FDA) as a nasal spray under the brand name Spravato. Clinical studies have demonstrated that esketamine can produce rapid antidepressant effects, often within hours to days, offering a significant advantage over traditional antidepressants, which typically require several weeks to achieve noticeable therapeutic benefits. Its use is generally incorporated into a broader, supervised treatment plan rather than as a standalone therapy.
Characteristics:
S-ketamine is characterized by a rapid onset of action and a shorter duration of effect. Its antidepressant properties are believed to arise from its ability to promote synaptic plasticity, enhance neural connectivity, and support adaptive changes in brain circuits associated with mood regulation.



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