Spravato® is the brand name prescription medication esketamine. It is FDA-approved therapy for treating adults with treatment-resistant depression and symptoms of major depressive disorder that include suicidal thoughts or behaviors.
About Spravato®
Spravato isn’t like oral antidepressant medications, such as serotonin reuptake inhibitors (SSRIs). Oral antidepressants generally boost levels of natural chemicals in the brain, such as dopamine, norepinephrine, and serotonin. And while this effect works for many patients, studies have shown that approximately one-third of all patients with depression fail to respond to traditional treatments of antidepressants and psychotherapy.
Spravato® therapy uses a nasal spray device to administer esketamine to the patient. Like ketamine, esketamine is an NMDA receptor antagonist. As such, Spravato® boosts glutamate, which is a neurotransmitter in the brain. Higher glutamate can help to encourage learning, boost memory, and train the brain to respond differently. All of these effects can help battle the effects of treatment-resistant depression and major depressive disorder.
Clinical trials of Spravato® have shown that it can positively affect depression symptoms by reducing the frequency of suicidal thoughts and strengthening or repairing damaged neurotransmitters, which can help develop new cell connections in the brain.
In addition to a different mechanism of action than oral antidepressants, Spravato® is especially effective in patients who suffer from suicidal ideation. Antidepressants often take weeks before the patient has any symptom relief. However, Spravato® is fast-acting, and patients can experience some symptom alleviation within hours, which is especially beneficial when trying to reduce or prevent suicidal thoughts.
Who can benefit from Spravato® treatment?
Spravato is FDA-approved for treatment-resistant depression and to treat symptoms of major depressive disorder that include suicidal thoughts or actions.
Treatment-resistant depression is often the diagnosis given to patients with depression that have tried at least two oral antidepressants without success. Patients that fall into this category and those that have major depressive disorder with suicidal thoughts are often good candidates for Spravato® therapy.
Who should not take Spravato®?
While Spravato® can benefit many patients with major depressive disorder, including suicidal thoughts and treatment-resistant depression, it’s not the right treatment for everyone. Those who should not use Spravato® therapy include:
- Those with a blood vessel disorder affecting the brain, chest, stomach, heart, arms, or legs.
- People with a history of aneurysm.
- Individuals with a history of bleeding in the brain.
- Those with an abnormal connection between the veins and arteries (arteriovenous malformation).
In addition to these patient groups, other groups may want to consult with their doctor before starting Spravato® due to the risk of complications or interactions.
- People with a history of substance abuse and misuse. Spravato® is administered at Spravato® treatment centers under the guidance of a qualified clinician. Despite this, there is a risk for physical and psychological dependence with Spravato®. If you have a history of abuse or substance dependence, you will want to discuss it with a qualified healthcare professional before starting Spravato® treatment.
- Those with heart or brain problems, including high blood pressure, slow or fast heartbeats that result in shortness of breath, chest pain, lightheadedness, or fainting, and those with heart valve disease. Additionally, any patients with a history of heart attack, stroke, brain injury, or any condition that results in increased pressure in the brain will want to discuss their medical history with a qualified clinician for taking Spravato®.
- Women who are pregnant, plan to become pregnant, or are breastfeeding or plan to breastfeed.
- Individuals with liver problems.
- Those with a condition called psychosis, which causes them to see, feel, or hear things that are not there or believe things that are not true.
If you start taking Spravato® to treat major depressive disorder or treatment-resistant depression, you will want to be aware of any potential side effects. These side effects may include increased blood pressure, problems thinking clearly, and bladder problems. Additional side effects may include dizziness, nausea, drowsiness, increased anxiety, and feelings of euphoria. Most side effects occur and resolve the same day Spravato® treatment is administered. Before taking Spravato®, you can access the complete prescribing information for additional details about potential side effects.
Some insurance plans cover Spravato® therapy, but not all. Janssen Pharmaceuticals offers several options for patients whose insurance does not cover treatment or who do not have insurance coverage.
If you believe Spravato® may be the right option to treat your treatment-resistant depression or major depressive disorder with suicidal thoughts, you can explore treatment options. Spravato® is only available at certified treatment centers and administered under the guidance of a qualified healthcare professional. To learn more about the benefits of Spravato® therapy, contact Memor Health to discuss potential treatment options.
