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Until now, the advice in the Diagnostic and Statistical Manual has been that people should not be medicated if their depression seems to be caused by the natural grief that follows bereavement. Esketamine is a nasal spray that must be administered in a healthcare setting that is certified in the REMS program where the healthcare provider can monitor the patient for sedation and dissociation for two hours after each dose. Patients may experience sedation (tiredness) and dissociation (difficulty with attention and thinking) after administration.

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