Spravato® Therapy

About Nasally Inhaled Esketamine Spravato™

Spravato is another treatment derived from ketamine that makes powerful antidepressant relief available to be delivered intra-nasally, similar to a common nasal decongestant.

Unlike antidepressants, which need to be taken every day, Spravato is only administered a couple of times each week: Two treatments per week for the first month, then one treatment per week for the second month, and one treatment every week or every two weeks for subsequent months.

Esketamine therapy patients generally report some sedation and disassociation effects during or shortly after the administration of the drug. Other side effects may include nausea, dizziness, vertigo, or headache.

Before starting esketamine therapy, we will discuss all potential side effects and interactions, and make sure Spravato is right for you.

What is esketamine therapy?

Esketamine, or Spravato, is the first nasal spray medication that is a treatment for depression. Combined with an antidepressant, Spravato is FDA-approved to treat depression and has been clinically shown to improve symptoms of depression over just 4 weeks.

Is Spravato therapy safe?

The most common side effects that can occur during and after taking Spravato include:
Dissociation, sedation, and numbness. Nausea, dizziness, a spinning sensation, feeling anxious, increased blood pressure, feeling drunk, and feeling very happy or excited have also been reported.

If Spravato side effects occur, they usually happen right after inhaling Spravato, or within 40 minutes, and go away the same day. Our staff members are available in the office to tend to patients who are experiencing side effects. In clinical trials, less than 7% of patients stopped Spravato treatment due to side effects.

How is this different than my typical antidepressant medication?

Unlike traditional antidepressants whose mechanism of action is mainly on serotonin, norepinephrine, or dopamine, Spravato works on the glutamate receptor.

What should I expect during treatment?

• Plan to be at our office for two hours.
• Patients are instructed not to eat for 2 hours before treatment.
• You can have fluid up to 30 minutes before treatment.
• You must have someone pick you up and drive you home after treatment.
• During treatment you are resting comfortably and being closely monitored
  by our medical team.
• You may need to hold medications such as benzodiazepines (e.g. alprazolam, clonazepam, lorazepam) or stimulants (e.g. Adderall, Vyvanse) on the day of treatment depending on your scheduled treatment time. Our treatment team with advice you on whether to make adjustments to your medication regimen prior to your first treatment.