After the VA announced in March it would offer a highly anticipated ketamine-based medication for treatment-resistant depression, a Department of Veterans Affairs panel voted last week against widespread use, instead restricting the drug for pre-approved, case-by-case treatment. The U.S. Food and Drug Administration on March 5 fast-tracked approval of Spravato, a nasal spray related to the anesthetic ketamine. Ketamine is also known in its illicit form as Special K, a party drug known for its disassociative effects, lending itself to abuse as a date rape drug. In prescription form, however, Spravato, or esketamine, has been hailed as a breakthrough treatment in a field with relatively few new options for treating unmanaged depression. VA officials lauded its arrival two weeks after Spravato received FDA approval, saying the treatment would be available to patients based on individual medical need and physicians' assessments. But the panel that decides which medications should be included among those readily accessible to VA physicians and patients — known as the VA's formulary — voted last week to leave Spravato off the list. The decision means doctors will need prior approval before prescribing and buying the medication for patients. Read more on Military.com.