SPRAVATO® (Esketamine) 

Spravato® (esketamine) is primarily used to treat depression, particularly treatment-resistant depression (TRD) in adults. It is prescribed when other antidepressants have not been effective in alleviating depressive symptoms. Spravato® (esketamine) is also used, in some cases, as part of a treatment plan for major depressive disorder (MDD) with acute suicidal ideation or behavior. This treatment is administered in a healthcare setting due to the need for monitoring after each dose.

Spravato® (esketamine) can cause sleepiness, dizziness, spinning sensations, or the feeling of being disconnected from yourself, your thoughts, space and time (dissociation). Be sure to review our pdf download for more information or contact us.

Spravato® (esketamine) has a relatively short half-life, ranging from 7 to 12 hours. Given this half-life, it generally takes about 2 to 3 days for esketamine to be eliminated from the body. However, the exact duration can vary based on several factors, including the individual’s metabolism, age, liver function, dosage, and frequency of use.

Although the drug itself is cleared from the system relatively quickly, its effects on the brain can persist for a longer period. This is one reason why patients are monitored closely after administration. Additionally, because Spravato® (esketamine) is typically used in a controlled clinical setting, healthcare providers and staff manage the dosing schedule to minimize potential risks.

The frequency of administration can vary depending on the phase of treatment and the patient’s response. Here is a general outline:

• Induction Phase (First 4 Weeks): Spravato® (esketamine)is administered twice a week with a monitoring period lasting two hours.
• Maintenance Phase: After the initial 4 weeks, the frequency is generally reduced to once a week. Depending on the patient’s clinical response, it may then be further reduced to once every 2 weeks.
  The exact dosing schedule can vary based on the patient’s condition, response to treatment, and the guidance of the healthcare provider. Regular follow-ups are important to adjust the dosing schedule as needed and to monitor for any side effects or adverse reactions.

A typical course of Spravato® (esketamine), with or without an oral antidepressant, ranges from three to four months. Continuation for longer periods of time depend on a provider’s consideration of other factors, including the patient’s severity of depression and ongoing clinical response to Spravato® (esketamine).

Spravato® (esketamine) has not been shown to cause weight gain from research studies. However, the oral antidepressant taken alongside Spravato® (esketamine) may contribute to weight changes, depending on the specific medication prescribed. If weight gain is a concern, discuss it with your healthcare provider.

Ketamine is a racemic mixture containing both R-ketamine and S-ketamine (Esketamine, or Spravato®). Esketamine, the active ingredient in Spravato® (esketamine), is a more potent form of ketamine, allowing for lower doses and potentially fewer side effects. Ketamine is often administered intravenously, while Spravato® (esketamine) is delivered via a nasal spray device. Spravato® (esketamine) is FDA-approved specifically for treatment-resistant depression (TRD) and major depressive disorder with acute  suicidal ideation (MDSI), while ketamine is used off-label for similar purposes.

Spravato® is not recommended for everyone. It may not be suitable for individuals who have:

• Blood vessel disease, such as aneurysm
• Abnormal connection between blood vessels (arteriovenous malformations)
• History of brain bleeding
• Certain heart, liver, or brain conditions
• An allergy to ketamine, esketamine, or any of the ingredients in Spravato®®
• History of psychosis or substance use concerns.

We will carefully review your full medical history before starting treatment to make sure Spravato® is safe and appropriate for you.

Like most medications, esketamine can cause side effects in some people. These may include:

• Drowsiness or sedation
• Dizziness or a spinning sensation
• Fainting
• Anxiety
• Breathing changes (respiratory depression or slow, shallow breathing)
• High blood pressure
• Feeling temporarily detached from your body, thoughts, or surroundings.

To ensure your safety while taking Spravato®, you’ll be closely monitored by our team before, during, and for at least two hours after each session. Tell us right away if you feel any chest pain, shortness of breath, vision changes, or sudden severe headache after taking Spravato®.

Taking Spravato® with certain prescription medications may cause side effects. Let us know if you are taking central nervous system (CNS) depressants, monoamine oxidase inhibitors (MAOIs), or psychostimulants.

Spravato® has not been approved for use in bipolar disorder or other mental illnesses. It is currently only FDA-approved for treatment-resistant depression (TRD) and major depressive disorder with suicidal thoughts and actions (MDSI).