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Spravato for Treatment-Resistant Depression

Spravato for Treatment-Resistant Depression

Inspired by the impressive efficacy of ketamine for depression, Spravato was awarded breakthrough status and fast-tracked for FDA approval in 2016. In March 2019, it was approved for the treatment of treatment-resistant depression in adults—and our Boston, MA and West Hartford, CT ketamine clinics are some of the first in the region to offer this groundbreaking antidepressant.

Here are some answers to frequently asked questions about Spravato for treatment-resistant depression:

What is Spravato?

Spravato is a prescription medication, used in conjunction with oral antidepressants, to alleviate the symptoms of treatment-resistant depression in adults. It is administered via nasal spray under the supervision of a physician or qualified nurse, in a clinical environment.

What is the difference between Spravato and ketamine?

Chemically speaking, Spravato is the isomer of the ketamine molecule—it’s chemical makeup is essentially a mirror image of ketamine’s. Spravato is administered via nasal spray, while ketamine is administered via IV infusion. Both medications have a high rate of success for the treatment of depression, though ketamine infusions may also be used to treat such conditions as anxiety, PTSD, bipolar disorder, postpartum depression, and more. Spravato must be used in conjunction with an oral antidepressant, while ketamine may be administered as a standalone depression treatment. Finally, Spravato may be covered by health insurance, while—in most situations—ketamine infusions are not. We can help you determine which medication will be more affordable for you based on your prescription coverage program.

Do I qualify for Spravato?

If you have tried two or more depression treatments for your most current depressive episode, but nothing has worked, then you should ask your physician if you qualify for Spravato. Patients with certain medical problems may not qualify for Spravato. Prior to beginning treatment, we will carefully review your medical history and determine whether or not Spravato is right for you.

What are the side effects of Spravato?

Common side effects include dissociation, dizziness, nausea, fatigue, nausea, and increased blood pressure. Rare but serious side effect include an increase in suicidal thoughts, and bladder problems. Ask your primary care physician or a member of our clinical team about the full range of Spravato side effects prior to receiving your first dose.

What should I expect on the day of my first Spravato treatment?

On the day of your first treatment—and every treatment thereafter—you will administer Spravato yourself, under the supervision of a qualified physician or nurse. The physician will take your blood pressure before and after treatment, and monitor your vitals for 2-hours post-treatment. During this time, most patients choose to relax, listen to music, or read. Because nausea is a common side effect of Spravato treatments, we recommend avoiding food for 2-hours prior to your appointment. You will not be allowed to drive for 24-hours post-treatment, so please be sure to arrange a ride with a friend or family member.

How often will I need to take Spravato?

During your first month of treatment, you will receive Spravato twice weekly. During your second month, you will receive Spravato once weekly. After that, you will receive treatments either once weekly or every other week, depending on your symptoms. Your prescribing physician will monitor your results and adjust your treatment plan as needed.

How long will it take Spravato to work?

Most patients experience reduced symptoms within 4-weeks of beginning treatment.

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