Since TMS does not circulate through the bloodstream, it is not associated with the common side effects of antidepressant medications such as dry mouth, upset stomach, dizziness, drowsiness, weight gain, or sexual dysfunction. Some patients report mild to moderate discomfort during the procedure, but these effects are temporary.

While treatments plans vary from patient to patient, TMS therapy easily fits into most daily routines without major disruption. A typical course of treatment lasts six to eight weeks depending on the patient’s response. The procedure is performed daily in sessions of about 30-45 minutes and patients can resume regular activities immediately after each session.

Electroconvulsive therapy, or “shock therapy,” is a considerably more intense treatment in which seizures are intentionally induced to treat depression. Patients undergoing ECT must receive general anesthesia and muscle relaxers to prevent the seizures from causing injury. Furthermore, ECT requires a significant amount of recovery time and patients are often put under close observation after treatment. Potential side effects of ECT include confusion and memory loss.

In contrast, TMS is a much safer procedure administered without any sedation. TMS is generally well tolerated, although some patients may experience mild to moderate discomfort.

Antidepressant medications (SSRIS, MAOIs, and tricyclics) do not interfere with ketamine, and there is no need to stop them. Patients taking large doses of benzodiazepines (Ativan, Xanax and Klonopin) will have a reduced response to ketamine, but taking these medicines does not mean that ketamine cannot help you.

Lamictal in doses over 100mg/day will blunt the ketamine response. Important: You should not decrease or stop taking any prescribed medication without first consulting your prescribing physician.

Response time varies from patient to patient. Some will begin to feel better within hours of the first infusion, while others may require multiple infusions before feeling improvement.

Patients with thoughts of self-harm often notice those thoughts dissipating first. There can be a dramatic relief of dread and hopelessness.

Unfortunately, since using ketamine therapy in the application of mood and anxiety disorders is still relatively new, insurance companies do not provide reimbursement yet.

There are very few. Your Lenox Hill Mind Care provider will discuss contraindications with you before you receive your first infusion.

Spravato® is a very safe depression medication in the hands of properly trained healthcare professionals.  It is FDA-approved for use as a treatment for depression, including treatment resistant depression.

Research over the last 5-10 years has shown that intranasal administration of Spravato® in sub-anesthetic doses remarkably benefits 70% of people suffering from severe depression. 

While the benefits can truly be remarkable, they often occur in ways that differ from some patients’ expectations. This is because the changes produced by Spravato® can be subtle, and while they can occur quickly, they do not always manifest themselves immediately. With this in

mind, we will work closely with you to identify and evaluate the benefits of Spravato.

At your initial consultation, a Lenox Hill Mind Care provider will complete an assessment of your medical and psychiatric history, and will discuss all your options regarding treatment for depression and assess if you are a good candidate for Spravato.

You are able to receive your first Spravato treatment once all insurance benefits and authorizations have been completed and reviewed with you by one of our patient care coordinators. You will also need to be enrolled in the Spravato REMS program.  This process can very and our team will keep you updated on the progress.

At your first Spravato visit, we will apply monitors to enable us to record your heart rate and rhythm, blood pressure, and oxygen level continuously throughout the treatment.

You will administer Spravato yourself under the supervision of a Lenox Hill Mind Care healthcare professional, who will show you how to use the nasal spray device.  Afterwards, we will monitor you for approximately 2 hours before you are released with an escort who can drive you safely home.    

You will be awake during the treatment and able to interact with those around you. It is best to relax quietly or listen to relaxing music during the session. We will provide an eye-mask, a small blanket, and noise-cancelling headphones with a relaxing playlist during your session.    

The cost of Spravato is dependent on your insurance plan. Janssen CarePath offers access and affordability options for patients, depending on your plan.  One of our dedicated patient care coordinators will review your expected costs with you before starting treatment.

Spravato should be administered in conjunction with an oral antidepressant. You should not stop your antidepressant medications. It is essential that we review your current medication list prior and throughout your Spravato treatment plan.

During the treatment, occasionally people experience nausea, mild non-threatening hallucinations, or dizziness. If you experience nausea, we are equipped to treat it with an anti-nausea medication.    

The most common side effects of Spravato® when used along with an antidepressant taken by mouth include:

• Feeling disconnected from yourself, your thoughts, feelings and things around you
• Feelings of euphoria or excitement
• Dizziness
• Nausea or vomiting
• Feeling sleepy/lethargic
• Decreased feeling of sensitivity (numbness)
• Increased blood pressure (temporary)

Your healthcare provider will monitor you for serious side effects for at least 2 hours after taking Spravato® and will decide when you are ready to leave the clinic.

Spravato (esketamine) is the s-enantiomer of ketamine. There are no head-to-head studies

comparing esketamine and ketamine infusions. Spravato (esketamine) is delivered in a nasal spray form and ketamine is delivered intravenously.

No, under the REMS, Spravato must be administered in a certified healthcare setting. Due to the possibility of delayed or prolonged sedation or dissociation in some cases, patients should be monitored by a healthcare professional for at least 2 hours following each treatment session, and the clinician determines the patient is safe to leave.