FREQUENTLY ASKED QUESTIONS ABOUT SPRAVATO
IS SPRAVATO SAFE?
Spravato is a very safe depression medication in the hands of properly trained healthcare professionals. Its use as a treatment for depression, including treatment resistant depression, and other mental health conditions. The appropriate dosage is determined by your physician, below those necessary to induce general anesthesia. Spravato is also frequently used to treat patients with treatment resistant depression.
IS SPRAVATO A RECREATIONAL DRUG?
Spravato is esketamine, however ketamine has been abused as a recreational drug. Street drug use is in doses vastly higher than the sub-anesthetic doses used for the treatment of depression and other mental health conditions. As mentioned above, Spravato is used legally and safely and is a very safe medication in experienced hands. Incidentally, many of the drugs used in anesthesia practice have the potential for abuse, so Spravato is not unique in this respect. The key is administering the right dose to the right patient in the right setting.
IS INTRANASAL SPRAVATO THE ONLY WAY TO DELIVER SPRAVATO FOR TREATMENT RESISTANT DEPRESSION?
Spravato is only administered intranasally. Unfortunately, the effectiveness and predictability of response and the overwhelming majority of scientific studies of Spravato for depression and mental health conditions have been performed using intranasal Spravato. In short, intranasal Spravato is the gold standard route for Spravato administration.
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. That is, the changes produced by Spravato can be subtle, and while they occur quickly, they do not always manifest themselves immediately. This phenomenon stands in contrast to some patients' expectations of a benevolent "thunderbolt" response from Spravato treatment. With this in mind, we will work closely with you to identify and evaluate the benefits of Spravato as a depression medication.
WHAT SHOULD I EXPECT DURING MY FIRST INITIAL SPRAVATO VISIT?
After we have received your medical and psychiatric history and completed acknowledgement of ongoing care by a mental health professional or primary care doctor, we will schedule an initial consultation. At the initial consultation, we will discuss all your options regarding treatment for depression and assess if you are a good candidate for Spravato intranasal administrations, you are welcome to receive your first Spravato treatment once all insurance benefits and authorizations have been completed. You would also need to be enrolled in the Spravato REMS program. The logistics are as follows: we will apply monitors to enable us to record your heart rate and rhythm, blood pressure, and oxygen level continuously throughout the treatment, then we begin the intranasal administration while you are seated with your head at 45-degree incline. Afterwards, we will monitor you for approximately 120 minutes (2 hours) before you are released with a friend or relative who can drive you safely home. 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. 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. The effects of Spravato wear off quickly, although we ask that you refrain from driving until the day after the treatment.Please do not eat solid foods, milk, pulp-filled juices or soup for 4-hours prior to your appointment. Youmay have clear liquids such as water, Gatorade, apple juice, black coffee or tea up to two hours prior toyour appointment.
HOW MANY INTRANASAL ADMINISTRATIONS DO I NEED?
The standard Spravato protocol for depression that has resulted from scientific trials and clinical experience around the U.S. is about 2 times per week for the first 4 weeks, and then weekly for 2 - 4 weeks and then maintenance. It has been shown that serial intranasal administrations are more effective than single intranasal administrations, and many patients who respond to Spravato treatment require maintenance intranasal administrations on an ongoing basis following the initial series. The frequency of these maintenance intranasal administrations varies greatly from person to person. It is important to note that Spravato intranasal administrations should not be viewed as a cure for depression, but rather a depression treatment that is a piece of a multi-modal approach that may include ongoing mental health therapy or other depression medication.
CAN I CONTINUE TO TAKE MY REGULAR MEDICATIONS?
Yes, you should not stop your antidepressant medications in order to receive Spravato. It is essential that we review your current medication list prior to beginning Spravato treatments.
IS SPRAVATO ADDICTING?
Spravato is not physically addicting but it could be psychologically addicting in those using it recreationally at much higher doses and in far greater frequencies than we will use. There is potential for abuse and misuse. Consider the risks and benefits of using Spravato prior to use in patients at higher risk of abuse. All patients will be monitored for signs and symptoms of abuse and misuse.