J&J’s blockbuster Spravato is setting the stage for managing psychedelics’ risks

Esketamine based Spravato is becoming a large scale depression treatment, and the article frames that success as a test case for managing psychedelics related risks. Spravato’s growth is discussed alongside ketamine’s history of dangerous recreational abuse, emphasizing that clinicians must balance fast acting, mechanistically relevant antidepressant benefits with the need for careful dosing, observation, and physician training. The discussion links Spravato to broader payer and access issues for psychedelic therapies, but stresses evidence based standards and patient safety over market enthusiasm. A psychiatrist points to a “perpetual balance” between subjective patient experience and objective medical benefit, noting that many patients do not respond. The article also situates Spravato within lessons from the opioid epidemic, arguing that prescribing and system level safeguards matter for preventing treatment regimens from going out of control. It mentions other psychedelics in the pipeline, including psilocybin and 5 MeO DMT, as part of the evolving regulatory and clinical conversation.