At Empire State Psychiatry, we are committed to offering our patients the most advanced and effective treatment options for a wide range of psychiatric conditions. Among the innovative treatments we provide is Spravato (esketamine), a groundbreaking medication designed to help individuals who suffer from treatment-resistant depression (TRD).
What is Spravato?
Spravato is an FDA-approved nasal spray that contains esketamine, a derivative of ketamine, which has been used for decades as an anesthetic and, more recently, has shown promise in treating depression. Unlike traditional antidepressants, which typically take weeks to show results, Spravato can begin to alleviate depressive symptoms within hours to days. This rapid onset of action makes it a particularly valuable option for those who have not found relief with other treatments.
Spravato is a prescription medication that offers a novel approach to treating depression, particularly for those who have not found success with traditional antidepressants. It is the first FDA-approved nasal spray specifically for adults with TRD, a condition where individuals do not respond adequately to at least two different antidepressant therapies.
How Spravato Works
Esketamine, the active ingredient in Spravato, works differently from conventional antidepressants. While most antidepressants target the neurotransmitters serotonin, norepinephrine, or dopamine, esketamine affects the brain’s glutamate system. Glutamate is the most abundant neurotransmitter in the brain and plays a crucial role in synaptic plasticity, which is essential for learning and memory. By modulating the glutamate system, esketamine can help restore neural connections that are disrupted in depression, leading to rapid improvements in mood and cognition.
The Spravato Treatment Process at Empire State Psychiatry
Spravato is administered in a controlled medical setting at Empire State Psychiatry, ensuring the safety and comfort of our patients. The treatment process involves the following steps:
Ongoing Support: Throughout the treatment process, patients receive comprehensive support from our psychiatric team, including regular check-ins and adjustments to their overall treatment plan to ensure optimal outcomes.
Initial Assessment: Before starting Spravato, our team of experienced psychiatrists conducts a comprehensive assessment to determine if Spravato is the right treatment for the patient’s specific needs.
In-Office Administration: Spravato is administered as a nasal spray under the supervision of a healthcare professional. The patient remains in the office for two hours following the administration to monitor for any potential side effects.
Follow-Up Sessions: Spravato is typically administered twice a week for the first four weeks, followed by weekly or bi-weekly sessions, depending on the patient’s response to the treatment. Our team closely monitors progress and adjusts the treatment plan as needed.
Potential Side Effects of Spravato
Like all medications, Spravato can cause side effects, though not everyone will experience them. Common side effects include dizziness, nausea, dissociation (a feeling of being detached from reality), and increased blood pressure. These side effects are generally mild to moderate and tend to subside shortly after the treatment session. Our team is trained to manage these effects and ensure the patient’s comfort throughout the process.
Is Spravato Right For You?
Spravato is a promising option for individuals who have not found relief with other antidepressant treatments. However, it is not suitable for everyone. During the initial consultation at Empire State Psychiatry, our psychiatrists will evaluate your medical history, current symptoms, and previous treatment responses to determine if Spravato is an appropriate choice for you.
FAQs
How does Spravato work?
Spravato acts on the glutamate system by blocking NMDA receptors, leading to increased neural connections and improved mood regulation. This mechanism differs from traditional antidepressants, which primarily target serotonin, dopamine, or norepinephrine.
Who is eligible for Spravato treatment?
Spravato is prescribed for adults diagnosed with treatment-resistant depression (TRD), which means they have not responded adequately to at least two previous antidepressant treatments. It is also indicated for individuals with major depressive disorder (MDD) who experience suicidal thoughts or behaviors.
How is Spravato administered?
Spravato is a nasal spray administered in a certified healthcare setting under medical supervision. Patients must remain at the facility for at least two hours after administration for monitoring due to potential side effects. The standard treatment schedule includes:
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Twice-weekly doses for the first four weeks
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Once-weekly doses for weeks five to eight
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Maintenance doses as determined by the healthcare provider
What are the common side effects of Spravato?
The most common side effects include the following. These effects typically subside after the treatment session.
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dizziness
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dissociation (feeling disconnected from reality)
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nausea
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feeling sleepy
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feeling a spinning sensation
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feeling anxious
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feeling numbness
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lack of energy
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increased blood pressure
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headache
Is Spravato the same as ketamine?
Spravato contains esketamine, which is a modified form of ketamine. While both drugs work similarly, Spravato is FDA-approved for depression and must be administered in a medical setting, whereas ketamine is often used off-label for depression in IV infusion therapy.
How soon does Spravato start working?
Some patients report noticeable improvement in depressive symptoms within hours or days of starting treatment. However, response times vary, and multiple doses may be needed to achieve significant benefits.
Can I drive after receiving Spravato?
No. Due to the sedative and dissociative effects, patients are advised not to drive or operate heavy machinery until the following day after a full night’s sleep.
Is Spravato covered by insurance?
Many insurance plans, including Medicare and Medicaid, cover Spravato for eligible patients. However, coverage varies by provider, and prior authorization may be required. Patients should check with their insurance company for details.
How long do I need to take Spravato?
The duration of treatment depends on individual response and the severity of depression. Some patients continue maintenance treatments, while others may transition off Spravato under their doctor’s guidance.
Is Spravato addictive?
Spravato has a potential for misuse due to its similarities to ketamine. However, it is administered under strict medical supervision in certified clinics, reducing the risk of misuse or addiction.
What should I do if I miss a dose?
If you miss a scheduled dose, contact your healthcare provider to determine the best course of action. Consistency in treatment is important for optimal results.
How does Spravato compare to other depression treatments?
Unlike traditional antidepressants, which can take weeks to show effects, Spravato may provide faster relief for severe depression. It is often used when other medications have failed to provide adequate improvement.
Where can I receive Spravato treatment?
Spravato is only available at certified healthcare facilities that follow the Risk Evaluation and Mitigation Strategy (REMS) program guidelines. Patients must take it under supervision in an approved treatment center.
Schedule a consultation
If you are exploring Spravato as a treatment option, schedule a consultation with the psychiatric providers at Empire State Psychiatry. Widely regarded as one of the top providers of advanced psychiatric care in New York City, Empire State Psychiatry is committed to delivering expert, patient-centered care. Their office is located in Midtown Manhattan, and they serve patients from the Upper East Side and surrounding New York City neighborhoods.