For people with depression that hasn’t responded to other treatments, a nasal spray called esketamine helps a little bit — and it works about as well as adding another type of psychiatric medication.

When people with severe depression that hasn’t responded to regular antidepressants get a nasal spray called esketamine along with their usual meds, they tend to feel a little better after a few weeks—about as much as if they added a different type of psychiatric pill.

A nasal spray called esketamine can help people with severe depression that didn’t respond to other treatments, by fixing how brain cells talk to each other and helping them form better connections.

In two people with severe depression that didn’t improve with other treatments, their symptoms got worse when their esketamine nose spray was given twice a week instead of once a week.

Some studies show that a nasal spray called esketamine helps with severe depression, but other bigger studies don’t show the same level of help—so scientists are confused about whether it really works as well as first thought.

For people with depression that hasn’t responded to other treatments, using a nasal spray called esketamine for six months may significantly help lift their mood, based on standard depression scores.