Spravato is the brand name for esketamine, a prescription medication used to treat treatment -resistant depression in adults. Esketamine is a form of ketamine, a dissociative anesthetic that has been repurposed at lower doses for its rapid-acting antidepressant properties. Spravato is administered as a nasal spray and works in conjunction with an oral antidepressant.
Spravato like ketamine, is recommended for adults facing the following challenges:
He is the first author of the TMS Guidelines that is the foremost authority of TMS practice principals across the world
If you have not responded to at least two antidepressant medications.
For individuals battling MDD and experiencing suicidal thoughts.
At Contemporary Care Centers, we prioritize the safety of our patients by implementing similar protocols to the REMS guidelines for Spravato (esketamine) treatments are performed under the close supervision of our trained mental health professionals.
Unlike traditional antidepressants that primarily affect serotonin, norepinephrine, and dopamine systems, esketamine works on the brain’s glutamate system. It specifically targets the N-methyl-D-aspartate (NMDA) receptor, leading to increased synaptic connectivity and rapid antidepressant effects.
Your healthcare provider will perform a thorough assessment to confirm that you have treatment-resistant depression and that Spravato is appropriate for you. This will include a review of your medical history, current medications, and any past responses to depression treatments.
You will receive detailed information about how Spravato works, the potential benefits and risks, the process of administration, and the monitoring that will take place during and after each treatment session.
We will get you approved to do Spravato therapy before you begin treatment. If you are actively suicidal, we can get approval within 1-2 working days and avoid hospitalization. We accept most insurances and Medicare which cover Spravato. Once approved, you may have a small copay but most of your costs will be covered by your insurance. Our insurance team is very skilled at getting and maintaining your coverage.
Before the administration of Spravato, your blood pressure will be checked to ensure it is safe to proceed. You might be advised to avoid food and beverages for a few hours prior to your appointment to minimize the risk of nausea.
Spravato is administered as a nasal spray. You will self-administer the spray under the supervision of a healthcare provider, typically while seated or lying down in a quiet, comfortable room. The nose spray contains two doses and each dose should be given in each nostril.
After administration, you will be monitored for at least two hours in the medical facility. Healthcare staff will check your blood pressure periodically and observe you for any immediate side effects such as dizziness, dissociation, or increased blood pressure. You'll need to relax and avoid strenuous activities.
You should arrange for someone to drive you home after the treatment, as you may feel drowsy, dizzy, or disoriented. You will be advised not to drive or operate heavy machinery until the following day.
The initial phase of treatment involves treatments twice a week for the first four weeks. Subsequent maintenance sessions might be reduced in frequency, typically to once weekly for four weeks, and then to once every two weeks or as recommended by your healthcare provider.
Similar to the first session, each treatment will include pre-dose checks (e.g., blood pressure) and post-dose monitoring for at least two hours after administration. You should report any unusual side effects or concerns to your healthcare provider.
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Common side effects include:
- Dizziness
- Dissociation (feeling detached from reality)
- Increased blood pressure
- Nausea or vomiting
- Headache
- Drowsiness
You will continue taking your oral antidepressant as prescribed during the Spravato treatment course. Psychological counseling or therapy might also be recommended to support your overall treatment plan.
Your healthcare provider will regularly evaluate your response to Spravato to determine its effectiveness and make any necessary adjustments to your treatment plan.
Spravato is only available through a Risk Evaluation and Mitigation Strategy (REMS) program due to its potential risks. Your treatment center must comply with REMS guidelines, and you will likely need to sign agreements acknowledging that you understand the risks and benefits of the medication.
Spravato is easily the fastest acting antidepressant currently available. Clinical trials have demonstrated that Spravato often produces rapid improvements in depressive symptoms, sometimes within hours to a few days of the first treatment. This is significantly faster than traditional antidepressants, which can take weeks to show effects.
In clinical studies, a notable proportion of participants with TRD responded to Spravato treatment:
The TRANSFORM-2 study reported that 52.5% of patients treated with Spravato and an oral antidepressant achieved a 50% reduction in their depressive symptoms at week 4, compared to 31% in the placebo group.
such as the SUSTAIN-1 study, showed that patients who continued with maintenance treatment of Spravato experienced sustained improvements and lower relapse rates compared to those on a placebo fir over 6 years.
These studies also indicate higher rates of remission (absence of significant depressive symptoms) in the Spravato groups compared to placebo.
. The ultrarapid response is sustained long-term when Spravato is continued every one to two weeks for several years. It is very unusual for a fast-acting treatment to have sustained benefits for several years. It makes Spravato a true game changer.
Some patients report significant improvements in their symptoms, while others may not find it as effective. We have some of the highest success rates with Spravato.
Spravato is used in conjunction with an oral antidepressant, and the combined treatment may contribute to its overall effectiveness.
Some patients may require ongoing treatments, while others might achieve lasting benefits after an initial treatment period.
Patients with more severe or long-standing depression might need longer treatment periods or may respond differently.
Patterns of response or resistance to other treatments may predict Spravato’s effectiveness.
The presence of other mental health conditions or physical health issues might influence the response to treatment.
While effective, Spravato can have side effects, and its benefits need to be weighed against these potential risks. Common side effects include dizziness, dissociation, and increased blood pressure. It is crucial to be monitored by a healthcare provider during treatment to manage any adverse effects properly.
Many patients experience improved mood, increased energy, and better overall functioning.
Standard depression rating scales used by healthcare providers often show significant improvements in scores following Spravato treatment.
We have compared the benefits of intranasal esketamine (Spravato) and standard ketamine infusions or lozenges and have not found any advantages to standard ketamine. Spravato is give under a carefully supervised REMS certified program at Contemporary Care. We found that it has fewer side effects than intravenous ketamine and is significantly cheaper. Most insurances including Medicare cover Spravato treatments while intravenous ketamine can cost the patent between $500-$700 per session. Some of our patients have needed to get weekly Spravato treatments for six years. Had this been intravenous ketamine the cost would have exceeded $150,000!
We are the one the most experienced Spravato practices in the Northeast and have treatment more patients for a longer time than most practices in the country. Our Clinical Director, Dr. Tarique Perera is a thought leader in the world of Spravato, lectures and trains other physicians on this treatment modality, and has served on Janssen’s Advisory Board for Spravato. Contemporary Care stands at the forefront as the premier SPRAVATO® center in Connecticut, offering cutting-edge treatment options for individuals seeking relief from depression. Our Spravato clinicians are the most compassionate, dedicated, and knowledgeable providers of therapy that you can find anywhere.
They take great pride in what they do and have generated some of the best outcomes. Our Spravato benefits team is able to get coverage faster and more extensively than most. With all these attributes, it no surprise that we have one of the best outcomes rates in the country. With a commitment to offering innovative and effective solutions for individuals facing mental health challenges, we take pride in providing Spravato as a source of renewed hope and healing.
Empower your healing journey today. Take the first step towards exploring the transformative benefits of Spravato therapy by scheduling an appointment with us. Your path to renewed hope and mental well-being starts here.
