Spravato is an intranasal medication that contains esketamine, which is a form of ketamine. It is used in conjunction with an oral antidepressant to treat adults with treatment-resistant depression. Esketamine works by modulating glutamate receptors in the brain, potentially leading to rapid relief of depressive symptoms. Unlike traditional antidepressants, Spravato has a unique mechanism of action and can provide relief more quickly.
Spravato is typically prescribed for adults who have not responded adequately to at least two different antidepressant treatments for their depression. These individuals may have treatment-resistant depression characterized by persistent and severe depressive symptoms. Eligibility for Spravato treatment is determined by a healthcare provider after a thorough assessment.
Spravato can cause various side effects, including dizziness, dissociation (feeling disconnected from reality), nausea, and increased blood pressure. These side effects are usually temporary and occur shortly after administration. Due to the potential for dissociation and sedation, individuals receiving Spravato must be monitored in a healthcare setting for at least two hours after each dose. Additionally, Spravato has a Risk Evaluation and Mitigation Strategy (REMS) program in place to ensure its safe and appropriate use.
The initial phase of Spravato is twice weekly administration for the first four weeks. Dosing then occurs once a week for another four weeks. Afterward, frequency may remain at once weekly, or may be reduced to once every two weeks depending upon the individual's response to treatment. A provider will work with each individual to adjust dosing based upon individual response and specific needs.
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