SPRAVATO (ESKETAMINE)
What is SPRAVATO?
SPRAVATO (esketamine) is a first-of-its kind nasal spray medicine approved by the FDA to treat adults with treatment resistant depression (TRD) and to treat depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior. SPRAVATO works in a unique way by targeting the brain’s NMDA receptors. While SPRAVATO and Ketamine are chemically related and function in similar ways, SPRAVATO is not the same as IV Ketamine.
What are the benefits of SPRAVATO?
In clinical trials of adults with treatment resistant depression, there was a greater reduction of depressive symptoms at four weeks in those treated with SPRAVATO compared to those who received a placebo and oral antidepressant. In a long-term maintenance trial, patients who continued SPRAVATO treatment were less likely to experience a return of depressive symptoms (known as relapse) compared to those who stopped therapy.
Who is a candidate for SPRAVATO?
SPRAVATO is only approved for treatment of adults with treatment resistant depression (TRD) and depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions. If you have not been diagnosed with either of the above, you are not a candidate for the treatment. If you don’t meet the requirements but are still interested in Ketamine treatment, you may still be a candidate for our Ketamine IV Therapy and can arrange a consultation with our clinical providers to discuss.
Does insurance cover SPRAVATO?
We will work with your insurance provider to confirm your coverage and your costs prior to SPRAVATO treatment. Our clinic does not determine the pricing. For insurance to approve this treatment you must currently be on one oral antidepressant medication, and you will need to have tried and failed at least two other medications of adequate dose and duration during your current episode. Not all insurance companies provide coverage, and treatment cost depends on your specific coverage. The spravato.com website has a dedicated Cost Support Affordability Support page that covers information about the cost and coverage of this treatment.
Where do I receive treatment?
SPRAVATO is available only through a restricted distribution program called the SPRAVATO REMS and will be administered under the supervision of one of our clinic health care providers at Springfield Psychiatry. You can expect to be at the clinic for a minimum of two hours each treatment day. A REMS program is in place to ensure the safety of all patients who are treated with SPRAVATO. The goals of the REMS are to mitigate the risks of serious adverse outcomes resulting from sedation and dissociation caused by SPRAVATO administration, and abuse and misuse of SPRAVATO, by ensuring SPRAVATO is only dispensed and administered to patients in medically supervised healthcare settings that monitor these patients.
What is the treatment duration?
If treatment is recommended, you will get enrolled in the program and follow the standard 8-week treatment plan, followed by an ongoing maintenance plan. During weeks 1-4 you will be administered SPRAVATO twice a week. During weeks 5-8 you will be administered SPRAVATO once a week. After eight weeks of treatment, we will determine the ongoing maintenance dosing frequency based on how you feel. It will either be once weekly, or once every other week. You and one of our medical professionals will decide how long you stay on Spravato based on how you respond to the medication.
What to expect on treatment days?
On your treatment days, you will need to arrange to be driven to and from our clinic. On the day of your SPRAVATO treatment, one of our providers will provide direct medical supervision to you as you self-administer SPRAVATO. You will then be provided with a comfortable area where you can relax while we monitor you after every dose for at least two hours for any immediate side effects or vital sign changes. Please keep in mind that after treatment and following the observation period, you should not drive or operate machinery until the day after a treatment session, after a night of restful sleep.
Side Effects?
SPRAVATO may result in side effects during and after treatment. Patients may experience sleepiness, fainting, dizziness, spinning sensation, anxiety, elevated blood pressure or feeling disconnected from yourself, your thoughts, feelings, space and time. Because of the risks for sedation, dissociation, and abuse and misuse, SPRAVATO is only available through a restricted program called the SPRAVATO Risk Evaluation and Mitigation Strategy (REMS) Program. This means that you can receive treatment with SPRAVATO only at treatment centers certified by the SPRAVATO REMS Program and you must be enrolled in the program. At Springfield Psychiatry, you can be assured that we have completed all of the requirements for REMS certification. The medical staff at our certified treatment center are trained to prescribe, dispense, and administer SPRAVATO, and we have established processes and procedures in accordance with the REMS requirements.
SPRAVATO Patient Video: Nicole's Story
SPRAVATO helped Nicole’s treatment-resistant depression. Now, she’s resuming her education and sharing her story.
SPRAVATO® Patient Video: What to Expect During Your SPRAVATO® Treatment
A patient-friendly video overview of the SPRAVATO® treatment process.
For more information about SPRAVATO, please refer to the manufacturer’s Prescribing Information and Medication Guide or visit www.spravato.com.