Esketamine Treatment

“TRD may be generally defined as a failure to respond to at least two different types of antidepressants for a period longer than 4 weeks at the maximum recommended dose.” 

Serafini, Howland, Rovedi, Girardi, & Amore, 2014

A first in decades approved by the FDA. Treatment-Resistant Depression can be frustrating, and in some cases, debilitating. Fast-acting improvement may be possible when combining SPRAVATO with your existing oral antidepressant.

What is SPRAVATO?

• • SPRAVATO (esketamine) is a medication administered intranasally in a medical office and requires medical supervision during treatment sessions.
  • SPRAVATO (esketamine) along with your antidepressant targets NMDA (N-methyl-D-aspartate) neuroreceptors and works differently than currently available oral antidepressants.
  • Ketamine is a NMDA receptor antagonist, a novel mechanism of action in treatment of depression, and accomplishes the goal of producing more dense neuronal spines in the pre-frontal cortex and restoring diminished synapses (Duman, Li, Liu, Duric, & Aghajanian, 2012).
  • Esketamine, an isomer or cousin of Ketamine, delivers the same effects and in some reported instances within 24-48 hours as opposed to weeks on IV Ketamine therapy (Caffrey, 2019).
  • SPRAVATO (esketamine) is not approved for anesthetic use and may not be safe for patients under 18.
  • Patients receiving SPRAVATO over four-week and sixteen-week experimental periods saw a significant reduction in depression symptoms compared to those who discontinued therapy or received a placebo.

 

What’s involved in receiving SPRAVATO treatment?

• • Begin a discussion with Dr. Gupta about SPRAVATO if you failed to get treatment response with two oral antidepressant therapies. It is important to evaluate if you are suitable candidate and likely to benefit from Spravato Rx.
  • Fill out easy to complete forms in order to clarify your benefits and reimbursements from your insurance. A representative from Spravato will inform you about your insurance coverage details.
  • Once approved and coverage is verified, YOU will be educated in detail about treatment schedule with nasal Spravato, including details of benefits, side effects, risks, duration of Rx and follow up plan.
  • Spravato can only be received from a ‘certified Spravato treatment center’.
  • Spravato nasal spray treatment will be administered under supervision of Dr Gupta and trained medical staff in a comfortable office set up.
  • Vital signs are monitored through out the procedure, lasting 2 hours, and a medical professional will be assessing your well-being throughout.
  • You must arrange for someone to drive you home or schedule a taxi/uber/lyft after treatment.

 

Are there any side effects to this medication?

The most common symptoms are:

• • • Dissociation
    • Spinning sensation
    • Dizziness
    • Nausea
    • Sedation
    • Anxiety; Vomitting, lack of energy
  • • An increase in Blood Pressure can occur so please let Dr. Gupta knows that if you have history of prehypertension, hypertension managed with medications, or have any family history of hypertension, aneurysm, or cardiovascular complications.
    • Patients rate the experience to be relaxing due to the sedative nature of the medication but a professional will be by your side during the treatment in the event any additional side effects occur.
    • Experiencing major side effects is rare, but Dr. Gupta and Staff are well-equipped to ensure your well-being and comfort.

 

Additional Topics to Discuss with Dr. Gupta

Are you pregnant, plan to become pregnant, or using contraceptive agents?

• • • SPRAVATO can have harmful effects on a developing fetus so taking SPRAVATO while pregnant or breastfeeding is not advised.

 

Sources: Spravato Website