Spravato (esketamine) is a recently released treatment for treatment-resistant depression (TRD). It is administered as a nasal spray, typically in conjunction with oral anti-depressants. Patients have shown a reduction in depression and suicidal ideation within just 24 hours from start of treatment, continuing to improve through the end of a four-week period. Sixty percent of patients have shown to have symptoms of depression reduced with continual treatment -- even after 80 weeks.
Spravato is given as an intranasal spray, which can be self-administered after consultation. For the first four weeks (induction phase), Spravato is to be taken twice weekly, then is only required to be administered once weekly or once every other week (maintenance phase).
Frequently asked questions
Is Spravato treatment right for me?
Spravato (esketamine) has been found to be useful for patients who have not experienced full relief of depression from at least two traditional antidepressant medications. Prior to being scheduled for Spravato, your provider will give you a full psychiatric evaluation to determine if you qualify for esketamine treatment.
What should I expect the day of my treatment?
You will be monitored very closely during your Spravato treatment. This will include blood pressure, pulse measurements, and some psychological measurements before and after your session.
How does it work?
A low dose of Spravato will be administered via intra-nasal spray. After five minutes another small dose will be administered. Your provider will monitor you for a two hour waiting period. We encourage you to wear eye shades, listen to relaxing music, and focus inward during this time
Does it have any side effects?
Spravato's side effects wear off quite quickly; you will be able to return home about 2 hours after treatment is complete. Patients are required to have another person drive them home. You should not drive until the next day after a restful sleep.
During treatment, patients may experience an altered or dream like state, which most describe as very pleasing..
Will my insurance cover Spravato treatment?
Some do some don't. Our office is in the process of finding out which ones will and are fighting to get answers.
Developed by Johnson & Johnson’s subsidiary, Janssen Pharmaceuticals, esketamine is marketed under the name Spravato and dispensed as a nasal spray administered under the supervision of trained health care professionals.
Ketamine is the chemical mixture of esketamine and arketamine, two mirror-image molecules. But when the molecules are separated, esketamine has been shown to be more potent. As a result, it requires a lower dosage and has a decreased risk of disassociation, tolerance and abuse.
“That’s why Janssen preferred to develop esketamine. It has more robust antidepressant efficacy with less side effects,” said Rodrigo Machado-Vieira, M.D., Ph.D., professor of psychiatry and behavioral sciences and director of the Experimental Therapeutics and Molecular Pathophysiology Program at UTHealth Harris County Psychiatric Center. “It’s the most striking discovery in psychiatry in the past 34 years at least, so I’m very excited.”