What is Spravato®?
Spravato is an FDA-approved prescription nasal spray used to treat depression and other mood disorders.
Can Spravato® be used with other medications?
Spravato® is used in combination with an oral antidepressant medication and therefore you should NOT stop your antidepressant medications in order to receive Spravato. However, it is essential that your current medication list is reviewed with our psychiatrists prior to beginning Spravato treatments.
Can Spravato® help me?
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 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.
How much does Spravato® cost?
The cost of Spravato is dependent on your insurance plan.
One of our dedicated patient care coordinators will review your expected costs with you before starting treatment.
Is there a difference between Spravato® Nasal Spray and Ketamine IV?
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 infusions are delivered intravenously.
The mechanism of action of esketamine is similar to that of ketamine, with the main pharmacodynamics action being the NMDA glutamate receptor antagonist. Taken together, compared to placebo, intranasal esketamine increases the chances of response and remission in treatment-resistant depression.
What should I expect BEFORE my Spravato® visit?
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.
Schedule:
- The index course of Spravato lasts 8 weeks.
- Weeks 1-4: the nasal spray medicine is administered twice a week
- Weeks 5-8: the nasal spray medicine is administered once a week
(the timeline and frequency of booster shots is assessed on an individual basis with our psychiatrists)
What should I expect DURING my Spravato® visits?
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.
You will be awake during the treatment and able to interact with those around you. It is best to relax quietly while listening to curated music during the session. We will provide an eye-mask, a small blanket, and noise-cancelling headphones with a relaxing playlist during your session.
Each appointment will last about 2 hours.
AFTER your Spravato treatment, the effects of the medicine wear off quickly, but you will still be monitored for about an hour before you are released. You can use this time to relax and journal any insights from the session. We will make sure that you feel fully recovered and have a safe way to get home.
You are NOT to take Spravato® if you have the following:
- blood vessel (aneurysmal vascular) disease (including in the brain, chest, abdominal aorta, arms and legs)
- an abnormal connection between your veins and arteries (arteriovenous malformation)
- a history of bleeding in the brain
- allergy to esketamine, ketamine, or any of the other ingredients in SPRAVATO®
What are the possible side effects of Spravato®?
The most common side effects of Spravato® when used along with an antidepressant taken by mouth include:
- Mild non threatening hallucinations
- Feeling disconnected from thoughts, feelings and things around you
- Feelings of euphoria or excitement
- Dizziness/ Vomiting (if this occurs, we are equipped to treat it with an anti-nausea medication)
- 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.
The Science Behind Spravato®
Spravato targets the glutamate system in the brain, which plays an important role in healthy brain functioning.
Glutamate is a highly abundant neurotransmitter, responsible for facilitating signals between nerve cells.
Spravato or Esketamine is FDA-Approved and a prescription nasal spray for use in conjunction with an oral antidepressant in adults with depression who have not responded adequately to antidepressants. Spravato targets the glutamate system in the brain, which plays an important role in healthy brain functioning. Glutamate is a highly abundant neurotransmitter, responsible for facilitating signals between nerve cells.
Although Spravato’s exact mechanism of action is not yet known, it’s thought to create new connections in the brain, allowing for behavioral and cognitive changes to occur more readily and rapidly in patients with treatment-resistant depression. Clinical trials have shown a 69% response rate and 52% remission rate in patients treated with Spravato.
SPRAVATO™ is only available at Risk Evaluation and Mitigation Strategy (REMS) certified facilities. Lenox Hill Mind Care is REMS certified. The medical staff have been trained to prescribe, dispense and administer SPRAVATO™ and have established processes and procedures in accordance with the REMS.
Our practice has been focused on treating TRD (treatment-resistant depression) patients since we were founded in 2009. We are committed to providing the most innovative patient-centric care to give our patients the best chance for recovery.