SPRAVATO® (esketamine) is a game changer in the realm of mental health treatment, specifically designed for individuals facing treatment-resistant depression (TRD) and major depressive disorder (MDD) with acute suicidal ideation or behavior. Here’s what you need to know about this innovative therapy we offer.
What is SPRAVATO®?
Spravato (esketamine) is a prescription nasal spray used to treat treatment-resistant depression (TRD) and major depressive disorder (MDD) with acute suicidal ideation or behavior in adults. It works by targeting the NMDA receptor, which is different from traditional antidepressants that primarily act on serotonin, norepinephrine, or dopamine pathways.
How does SPRAVATO® work?
Spravato (esketamine) works by targeting the NMDA receptor in the brain, which is different from traditional antidepressants that primarily act on serotonin, norepinephrine, or dopamine pathways.
Here's a brief overview of how it works:
Administration: Spravato is administered as a nasal spray in a certified healthcare setting under direct supervision
Mechanism: It blocks NMDA receptors, which are involved in the regulation of mood and cognition
Rapid Relief: It can provide rapid relief from depression symptoms, often within hours
Monitoring: Patients are monitored for at least two hours after administration due to potential side effects like sedation and dissociation.
What are the side effects of SPRAVATO®?
Spravato (esketamine) can cause a range of side effects, from mild to serious. Here are some of the most common ones:
Common Side Effects
Sedation (excessive sleepiness)
Dissociation (feeling detached from reality)
Dizziness
Nausea and vomiting
Vertigo (sensation of spinning)
Headache
Blurred vision
Anxiety
Serious Side Effects
Increased blood pressure
Respiratory depression
Suicidal thoughts and behaviors
Abuse and misuse potential
Patients are monitored for at least two hours after administration due to these potential side effects.
Who should not use SPRAVATO®?
Spravato (esketamine) should be avoided by individuals with certain medical conditions due to potential risks. Here are some key contraindications:
Aneurysmal vascular disease: This includes conditions like thoracic and abdominal aortic aneurysms, intracranial aneurysms, and peripheral arterial aneurysms
Arteriovenous malformation: An abnormal connection between arteries and veins
History of bleeding in the brain: This includes conditions like hemorrhagic stroke
Allergy to esketamine or ketamine: Individuals with known allergies to these substances should not use Spravato
Patients who are pregnant or breastfeeding
It's important to discuss your medical history with your healthcare provider to determine if Spravato is safe for you.
Who can receive SPRAVATO® Therapy Treatment?
Eligibility Criteria
Treatment-Resistant Depression (TRD): You may qualify if you have tried at least two different antidepressants at adequate doses without significant improvement
Major Depressive Disorder (MDD) with Suicidal Thoughts: If you experience frequent, severe depressive episodes that include suicidal ideation, Spravato may be recommended to stabilize your condition.
Combination Therapy: Spravato must be used in combination with an oral antidepressant (such as an SSRI or SNRI) for the best results.
Medical Clearance: Some health conditions may make Spravato unsafe, including uncontrolled high blood pressure, a history of substance abuse, or certain cardiovascular issues.
A thorough medical evaluation will determine if you’re a good candidate.
Benefits of SPRAVATO® Therapy
Spravato (esketamine) offers several benefits for individuals with treatment-resistant depression (TRD) and major depressive disorder (MDD) with acute suicidal ideation or behavior. Here are some of the key benefits:
Rapid Relief
Quick Onset: Unlike traditional antidepressants that can take weeks to show effects, Spravato can provide relief from depressive symptoms within hours to days.
Effectiveness
For TRD: It is specifically effective for individuals who haven't responded to at least two other antidepressants.
Suicidal Ideation: It helps reduce suicidal thoughts and behaviors in patients with severe depression.
Mechanism of Action
NMDA Receptor Targeting: By blocking NMDA receptors, Spravato helps restore synaptic connections and improve mood.
Combination Therapy
Enhanced Results: When used in combination with an oral antidepressant, it can enhance overall treatment outcomes.
Controlled Administration
Supervised Use: Administered in a certified healthcare setting, ensuring patient safety and monitoring for side effects
What does a SPRAVATO® visit look like?
A Spravato (esketamine) visit typically involves several steps to ensure safety and effectiveness. Here's what you can expect:
Before the Visit
Preparation: You'll need to arrange transportation since you won't be able to drive after the treatment.
Medical Evaluation: Your healthcare provider will review your medical history and current medications to ensure Spravato is appropriate for you.
During the Visit
Arrival: You'll check in at a certified healthcare setting, such as a clinic or hospital.
Administration: Spravato is administered as a nasal spray under direct supervision.
Monitoring: You'll be monitored for at least two hours after administration to observe any side effects like sedation or dissociation.
Environment: The setting is designed to be comfortable and calming, often with dim lighting and quiet surroundings.
After the Visit
Recovery: You'll need to rest and avoid driving or operating heavy machinery for the rest of the day.
Follow-Up: Your healthcare provider will schedule follow-up visits to monitor your progress and adjust treatment as needed
Discuss with your provider if SPRAVATO® is right for you
If you’d like to schedule an appointment to discuss this treatment to explore if you’re a good candidate, follow the instructions here. Please include you are interested in Spravato therapy.
Referring providers can find our Spravato referral form under the forms section of our site.