Key Takeaways
Risks and treatment options during pregnancy:
- SPRAVATO® risk alert: Animal studies show potential fetal harm during pregnancy.
- Use caution: Not recommended for pregnant women unless absolutely necessary.
- Explore safer options: Providers may suggest alternative therapies like TMS or psychotherapy.
- Breastfeeding concern: Monitor infants for drug exposure and respiratory effects post-treatment.
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Navigating SPRAVATO® during pregnancy involves more than just weighing options—it’s about making informed, timely decisions that prioritize your health and your baby’s well-being. If you’re managing treatment-resistant depression, you may already be exploring ketamine-based treatment options like SPRAVATO (an esketamine nasal spray) that offers relief when other therapies fall short. But how does this rapid-acting medication fit into your plan if you’re pregnant or planning to be?
SPRAVATO®, Ketamine, and Esketamine: Where Safety Meets Uncertainty
Derived from ketamine, SPRAVATO works differently than traditional antidepressants. It targets glutamate pathways and is only administered to pregnant women when absolutely necessary. Under the supervision of a healthcare provider, each treatment session takes place at a certified SPRAVATO treatment center. This model ensures use by healthcare professionals trained to monitor serious depressive symptoms in adults, including suicidal thoughts tied to major depressive disorder.
However, the effect of SPRAVATO on human pregnancy isn’t fully understood. According to clinical studies by Janssen Pharmaceuticals, pregnancy in rats resulted in developmental harm. When SPRAVATO was administered during gestation, the data showed it may cause fetal harm. While these animal findings don’t confirm outcomes in humans, they highlight an increased risk. That’s why the official SPRAVATO Medication Guide states it’s not recommended for use during pregnancy.
Depression During Pregnancy: What to Weigh With Your Healthcare Provider
Untreated depression in pregnancy can lead to serious consequences. It’s been linked to an increased risk of suicidal thoughts, early delivery, and other poor pregnancy outcomes. That doesn’t mean treatment should be discontinued outright. Instead, your provider might explore options beyond the use of SPRAVATO, including:
- Gradually reducing the dose of SPRAVATO under clinical monitoring
- Combining nasal spray plus oral antidepressant therapies with a safer pregnancy category rating
- Exploring behavioral approaches like TMS or structured psychotherapy
If you’re pregnant while being treated or have been treated with SPRAVATO, we support joining the National Pregnancy Registry for Antidepressants. Your provider is encouraged to register patients, especially women exposed to esketamine, to expand research into fetal outcomes and guide better care.
Planning to breastfeed? Be sure to discuss potential drug transfer and SPRAVATO nasal exposure with your team. While limited data exists for pregnancy or while breastfeeding, monitoring newborns for respiratory depression is advised during this period.
Your Next Step If You’re Considering SPRAVATO During Pregnancy
The SPRAVATO WithMe provider portal connects you to up-to-date resources, appointment tracking, and personalized support—all built around your unique care journey. If you’ve been exposed to SPRAVATO, your team will assess how the effect of SPRAVATO on your symptoms of depression compares to any risk it may cause your developing baby.
Through the SPRAVATO WithMe program, you’re not just handed resources—you’re partnered with professionals who can help you choose whether to continue, modify, or pause treatment. If you’re seeking answers about therapy during pregnancy or while breastfeeding, we guide you toward a care plan that respects your needs and your child’s safety.
Conversations about SPRAVATO during pregnancy can feel overwhelming, but with Memor Health, you’ll never make those decisions alone.
