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The Food and Drug Administration on Tuesday approved esketamine, the first major depression treatment to hit the U.S. market in decades and a new option for patients who haven’t responded to existing therapies.

Esketamine — developed by Johnson & Johnson and delivered as a nasal spray — was tested in combination with oral antidepressants in patients with what’s known as treatment-resistant depression. The drug is related to ketamine, a common anesthetic that’s sometimes misused recreationally. Many experts have hailed esketamine as a critical option for patients in dire need of new treatments — particularly because it might work faster than existing antidepressants.

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“The unmet need is really huge,” said Dr. Husseini Manji, the global head of neuroscience therapeutics at Janssen, the subsidiary of Johnson & Johnson that developed the drug, which will be called Spravato.

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