Spravato (Esketamine)
Spravato (esketamine) is a prescription medication that is used to treat treatment- resistant depression (TRD) and major depressive disorder (MDD) in adults. It is a nasal spray that contains esketamine, a chemical compound closely related to ketamine, which has been used for many years as an anesthetic and more recently investigated for its potential antidepressant effects. Spravato is generally prescribed for individuals who haven't responded well to other antidepressants. It is typically used in conjunction with an oral antidepressant, as part of a broader treatment plan. Here’s a breakdown of key points about Spravato:
1. Mechanism of Action:
Esketamine works differently than traditional antidepressants, which often target serotonin, norepinephrine, or dopamine systems. Spravato is thought to affect the glutamate system in the brain, particularly by interacting with NMDA (N-methyl-D-aspartate) receptors. This can result in faster antidepressant effects compared to traditional medications, which may take weeks to show benefits.
2. Administration:
Spravato is administered as a nasal spray under the supervision of a healthcare professional in a certified healthcare setting. This ensures proper monitoring, as the medication can have side effects like dizziness, sedation, and dissociation shortly after use.
3. Efficacy:
Clinical studies have shown that Spravato can provide significant relief for people with treatment-resistant depression, often with faster effects than traditional antidepressants. However, its exact long-term effectiveness and safety profile are still being studied.
4. Side Effects:
Common side effects include dizziness, nausea, headache, and feelings of dissociation or altered perception. These effects are why Spravato must be administered in a healthcare setting with monitoring for at least two hours after use to ensure patient safety.
5. Approval:
Spravato was approved by the U.S. Food and Drug Administration (FDA) in 2019 for treatment-resistant depression. It is available through a restricted distribution program called the SPRAVATO REMS (Risk Evaluation and Mitigation Strategy), which ensures the medication is given with appropriate safety precautions.
​
6. Cost:
Spravato is expensive, and its cost can vary. Because it’s often used in conjunction with other antidepressants, the total cost of treatment can add up, leading some insurance companies to limit coverage. Financial assistance programs may be available.
In summary, Spravato (esketamine) is a nasal spray medication used to treat treatment- resistant depression (TRD) and major depressive disorder (MDD) in adults. It works by affecting the glutamate system in the brain, offering faster antidepressant effects compared to traditional medications. Spravato is administered under the supervision of a healthcare provider, as it can cause side effects like dizziness and dissociation. Approved by the FDA in 2019, it is typically used alongside an oral antidepressant and requires monitoring after use due to its potential side effects.