Spravato is the brand name for esketamine, a nasal spray medication approved by the FDA in 2019 for treatment-resistant depression. Treatment-resistant depression (TRD) is classified as depression that does not respond to other treatment interventions, usually referring to the success of oral antidepressant medications. Esketamine is an enantiomer of ketamine, which has been medically used as an anesthetic for decades. However, studies have recently shown its rapid antidepressant effects leading to the development of Spravato as a treatment specifically for treatment-resistant depression.
Spravato’s mechanism of action is different from traditional antidepressants, which usually target serotonin and norepinephrine in the brain, as it influences the brain’s glutamate system. Glutamate is believed to be involved in neural communications and plasticity of the brain, the brain’s ability to change and adapt throughout your life by forming new connections and reorganizing existing ones. Therefore, Spravato is believed to help restore the connections between brain cells that may be disrupted in people with major depressive disorder.
Spravato treatment expectations
If you are considering reaching out to a Spravato center for treatment, it is important to understand what to expect from the treatment process. Unlike traditional antidepressants that can be taken at home, Spravato is administered in healthcare settings under the supervision of a medical professional. This is to ensure safety, as Spravato is classified by the FDA as a class III controlled substance and requires an observation period to monitor patients after administration.
(1) Pre-treatment Assessments; (2) Frequency of Treatment; (3) Administration; (4) Observation; (5) Monotherapy
1. Before starting treatment, a physician will assess your mental health history and discuss your symptoms, as well as, all the options that have been exhausted to treat your depression. It is important to discuss your options with your current mental health provider and a Spravato-approved treatment facility to make an informed decision for your mental health.
2. Initially, Spravato is administered twice a week for the first month. Afterward, the frequency may be reduced based on your response to the treatment. Some patients find they only need monthly sessions once their depression has stabilized.
3. On the day of treatment, you will visit a certified healthcare facility where a trained professional will help you administer the nasal spray. The treatment session will last 2 hours to monitor reactions and side effects. Side effects of Spravato usually last around the first hour of treatment and gradually fade naturally throughout the 2 hours. Depending on the facility, you may have a personalized room with different amenities to make your experience comfortable and relaxing.
4. After administration, you’ll be monitored for at least two hours to ensure that you do not experience any adverse reactions. Common side effects include dizziness, drowsiness, or acute feelings of dissociation that usually subside after a short time. Remember though that not everyone will experience the same side effects or at the same severity, which is why the 2 hours of monitoring is important to check efficacy and safety.
5. Its approval as a monotherapy, as of January 2025, simplifies the treatment and reduces the need for complex medication regimens that is demanded for both patients and doctors. Spravato is a stand-alone treatment––meaning it is not required to be used in conjunction with an oral antidepressant for patients who do not react well to the most oral antidepressant. However, it can be used in conjunction with an oral antidepressant to provide more comprehensive relief. The approval as a monotherapy approach ensures that you’re tackling your depression from multiple angles, enhancing the likelihood of a successful outcome. Your healthcare provider will guide you in incorporating Spravato into your treatment plan.
Treatment-Resistant depression
One of the most significant challenges with treatment-resistant depression is that conventional medications don’t seem to work. These medications often take weeks to show effects, and in many cases, they fail to provide adequate relief. In contrast, Spravato works much faster, often providing relief in as little as two hours after administration. This rapid onset of action has been a game-changer for many individuals who feel they’ve exhausted all other options.
The mechanism of action behind Spravato is unique. It’s thought to stimulate the production of new synaptic connections between neurons, helping to “reboot” the brain’s neurochemical pathways. This reactivation of the brain’s natural plasticity process can lead to improved mood, cognition, and overall functioning, which many patients with TRD have found life-changing.
Potential side effects
Like all medications, Spravato can have side effects. While most side effects are mild and temporary, it’s important to be aware of potential risks. Some individuals experience dizziness, nausea, or fatigue after administration. Most noticeable side effects can include a slight increase in blood pressure or acute dissociation, so close monitoring by healthcare providers is necessary. It’s also worth noting that Spravato has the potential for misuse, as it is derived from ketamine, a substance with a history of recreational use. For this reason, Spravato is only available in certified healthcare settings and is closely regulated.
Benefits of consider Spravato
Treatment-resistant depression (TRD) can feel like a relentless battle for those who suffer from it. Despite trying numerous therapies, including medications and talk therapy, some individuals find no relief from their depressive symptoms. In recent years, a groundbreaking treatment known as Spravato has been introduced, offering hope for those struggling with TRD. For those battling treatment-resistant depression, Spravato represents a significant step forward in depression treatment.
Wilshire Institute for Interventional Psychiatry offers Spravato treatment for depression, a groundbreaking FDA-approved nasal spray designed for individuals with treatment-resistant depression (TRD). Our evidence-based approach creates personalized plans to optimize mental health outcomes and can be covered by most insurance plans. With a highly trained clinical team, we are committed to providing the best experience for our patients, guiding them through every step of the treatment process. Schedule a consultation with our experienced team today! If you or someone you know is struggling with severe depression that has not responded to other therapies, it may be time to talk to a doctor about Spravato as a potential treatment option. Always consult with a healthcare provider to ensure it’s the right choice for your specific condition and needs.
