{"id":2523,"date":"2020-06-04T03:08:26","date_gmt":"2020-06-04T03:08:26","guid":{"rendered":"http:\/\/psychiatryqbank.com\/?p=2523"},"modified":"2020-06-05T22:25:30","modified_gmt":"2020-06-05T22:25:30","slug":"the-new-world-of-intranasal-interventions","status":"publish","type":"post","link":"https:\/\/psychiatryqbank.com\/wordpress\/the-new-world-of-intranasal-interventions\/","title":{"rendered":"The new world of intranasal interventions"},"content":{"rendered":"\n

In psychiatry, we have been trying to reach the brain via various parenteral routes for a long time. Some historians claim that Neolithic \u2018trephination\u2019 observed in the Stone Age skulls may in fact be an attempt to treat psychiatric conditions 1<\/sup><\/a>. We have been spectacularly successful with some non-pharmacological parenteral therapies. Brain stimulation techniques are commonly employed \u2018parenteral\u2019 approaches forming a substantial portion of our prescribed treatments now. <\/p>\n\n\n\n

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The last decade has seen a less invasive pharmacological approach for parenteral therapy. Intranasal delivery of drugs seem to reach the central nervous system by directly crossing the blood-brain barrier via olfactory bulb pathways. For drugs that do cross this barrier effectively, intranasal delivery offers a means to circumvent the side effects of systemic administration.<\/p>\n\n\n\n

What drugs look promising in this regard?<\/p>\n\n\n\n

The 3 most promising agents at present are<\/p>\n\n\n\n

  1. Intranasal ketamine for depression<\/li>
  2. Intranasal oxytocin for various conditions where reduced empathy is prominent<\/li>
  3. Intranasal insulin for various neurodegenerative and cognitive syndromes2<\/sup><\/a><\/li><\/ol>\n\n\n\n

    Of these 3, the one that is ready for clinical use is the s-enantiomer of ketamine. You can find more information about the evidence for intranasal esketamine use in our Qbank materials.<\/p>\n\n\n\n