Spravato

If you struggle with treatment-resistant depression, Spravato™ may provide the help you need, delivering fast results so you can finally recover from ongoing depression. The team at Northwest Psychiatry & Counseling in Bentonville, Arkansas, regularly incorporates the use of Spravato™ into their clinical practice for patients with treatment-resistant depression. To learn more about this innovative medication and determine if you’re a good candidate, call the office or request an appointment online today. 

What is Spravato™ (esketamine)?

Spravato™ is the brand name for the prescription medication, esketamine, that’s produced by Janssen Pharmaceuticals, Inc. In March 2019, the United States Food and Drug Administration approved Spravato™ for use in adults with treatment-resistant depression when used in conjunction with an oral antidepressant.

Your depression is considered treatment-resistant when your depression doesn’t improve despite taking at least two antidepressants of adequate dose and duration. About 35% of adults taking antidepressants don’t respond to their medication.

Spravato™ is a nasal spray that your body absorbs through the nasal lining and directly into your bloodstream. It’s administered together with an oral antidepressant.

Spravato™ must be administered at a Spravato™ certified health care center such as Northwest Psychiatry & Counseling.

Spravato™ has not been approved for use as an anesthetic medicine to prevent or relieve pain. It isn't known if Spravato™ is safe or effective.  

How does Spravato™ work?

Spravato™ targets the N-methyl-D-aspartate (NMDA) receptor and is believed to work differently than oral antidepressants that are currently available. The exact way that Spravato™ works is unknown.

Most patients who experience improvement from Spravato™ have indicated that their symptoms improve within the first two weeks of treatment. During the clinical trials, most patients improved within the first 24-48 hours, with some patients needing four weeks of treatment before they got better.

Who is a candidate for Spravato™?

Patients interested in treatment with Spravato™ must schedule a consultation at Northwest Psychiatry & Counseling. During that consultation, your provider works on identifying if you’re a good candidate for Spravato™ treatment. The requirements at present are to have a diagnosis of treatment-resistant depression and to be taking an oral antidepressant; your insurance company may require other criteria.

How and for how long is Spravato™ taken?

Spravato™ is taken with a daily oral antidepressant. Patients will administer Spravato™ nasal spray themselves under the supervision of a Northwest Psychiatry & Counseling provider. Following the administration of Spravato™, patients will stay at Northwest Psychiatry & Counseling for 2 hours so they can be monitored for side effects. You’ll need to plan for rides to and from the office, as you should not drive or operate machinery until the day after a treatment session, following a restful sleep. Many patients bring a book, a relaxing playlist, or another form of entertainment for their session because of the two-hour monitoring period after treatment.

Spravato™ is taken two times a week for the first four weeks; then, the dosing is adjusted to once a week for another four weeks. After this treatment is provided at either weekly or biweekly intervals, some patients may be able to cease Spravato™ after the first eight weeks of treatment, but during the clinical trials, patients who stayed on Spravato™ longer tended to do better than those who stopped the medication.

Does Spravato™ cause side effects?

The most common side effects reported during the Spravato™ clinical trials included dissociation, dizziness, nausea, sedation, reduced sense of touch and sensation, anxiety, lack of energy, temporary increased blood pressure, vomiting, and the sensation of being drunk. It is important to remember that these are not the only possible side effects, just the most commonly reported. Each patient’s experience using Spravato™ may be different. Because of these possible side effects, patients must stay at Northwest Psychiatry & Counseling for two hours following treatment. For most patients, most, if not all, side effects will have subsided after two hours.

Because of the risk of side effects, we recommend that patients not eat or drink for two hours before receiving treatment with Spravato™.

Additionally, during the Spravato™ clinical trials, less than 5% of patients discontinued treatment due to side effects.

How were the side effects of Spravato™ determined?

The safety and benefits of Spravato™ were studied in a clinical program involving short- and long-term trials that observed 1,700 adult patients with treatment-resistant depression. The trial compared patients who used Spravato™ with an oral antidepressant to patients who used a placebo nasal spray with an oral antidepressant. These studies evaluated the efficacy and safety of Spravato™ in both short-term and long-term studies for up to one year.

To learn if you’re a good candidate for Spravato™, call Northwest Psychiatry & Counseling or request an appointment online today.