A new ketamine-like nasal spray will soon be available at a subsidised cost in Australia to help thousands living with treatment-resistant depression. The medication, called Spravato (esketamine), has been added to the Pharmaceutical Benefits Scheme (PBS), marking a significant shift in how the country approaches difficult-to-treat mental health conditions.What Is Esketamine and How Does It Work?Esketamine is chemically related to ketamine, a well-known anaesthetic that gained notoriety for recreational use in rave culture. However, in controlled medical settings, this compound is offering new hope for patients who have not responded to traditional antidepressants.Unlike older medications that target serotonin – a “feel-good” chemical in the brain – esketamine works on a different neurotransmitter called glutamate. This chemical is believed to play a key role in restoring neural connections that influence mood regulation. The result is often a much faster response, with some patients feeling relief within hours instead of weeks or months.Why It Matters: A Breakthrough After DecadesEsketamine is the first government-funded drug for major depression in over 30 years that works via a new mechanism. While most antidepressants developed since the 1980s have focused on serotonin or other monoamines, esketamine offers an alternative path by targeting glutamate and related brain circuits.For those who have tried multiple medications without success, this drug represents a long-awaited option. Clinical trials in Australia show that nearly 50% of patients with treatment-resistant depression reported significant improvement after using esketamine.Who Can Access It and What Will It Cost?Starting Thursday, up to 30,000 Australians will be able to access Spravato through the PBS. Patients will pay $31.60 per dose, or $7.70 for pensioners and concession card holders. However, this does not include additional healthcare and administrative fees. Because of safety requirements, the drug must be administered under supervision at certified treatment centres, which will add to the overall cost.Despite these extra expenses, making esketamine available through PBS is expected to reduce financial barriers and give more Australians access to potentially life-changing care.Why Esketamine Stands OutSince receiving approval from the US Food and Drug Administration (FDA) in 2019, esketamine has been used in hospitals and clinics across America, particularly in emergency care for severe depression. Unlike some drugs that sedate or numb emotions, esketamine is reported to alleviate core depressive symptoms — including intense feelings of hopelessness and suicidal thoughts — without dulling awareness.Mental health experts say this rapid effect can be life-saving in critical cases where waiting for standard medications to take effect is not an option.A Step Forward After Long DelaysThe inclusion of Spravato in the PBS comes after a four-year wait and four separate funding submissions. The listing is seen as a major win for mental health advocates and patients who have pushed for broader access to advanced treatments.While it may not work for everyone, esketamine opens a new chapter in treating depression — one focused on faster, more targeted relief for those who need it most.