Ketamine Therapy

Is Spravato Safe? Addressing Concerns About Spravato Therapy

7 min read

Spravato, FDA-approved for treating treatment-resistant depression (TRD), addresses a specific form of depression that hasn’t responded to at least two different antidepressants. Your doctor will diagnose TRD based on your previous antidepressant usage. Spravato is specifically approved for use in adults and is administered in combination with at least one other oral antidepressant. However, concerns about the safety of Spravato, a form of ketamine therapy, have arisen. To help you determine if this treatment is suitable for you, we’ll address some of these concerns about Spravato ketamine therapy.

What is Spravato (esketamine)?

Spravato (esketamine) is a nasal spray prescribed for specific types of depression. Approved by the Food and Drug Administration (FDA), it contains esketamine and is indicated for treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal thoughts or actions. Unlike traditional antidepressants, which increase levels of naturally occurring brain chemicals like dopamine and serotonin, Spravato acts on glutamate, a primary neurotransmitter. Spravato works by enhancing glutamate activity, which stimulates brain cell communication, promoting positive moods and potentially alleviating depression symptoms. Clinical trials have suggested that Spravato can reduce suicidal thoughts and strengthen neurotransmitters, which can potentially foster brain cell connections.

How Spravato does it differ from traditional ketamine?

Spravato which is designed specifically for Treatment-Resistant Depression (TRD), targets specific neural pathways to enhance mood regulation. It is the brand name for esketamine, often confused with ketamine, an anesthetic. While chemically similar, Spravato and ketamine have key differences. Spravato’s active ingredient is esketamine, a derivative of ketamine, but their effects on the body vary. Ketamine primarily functions as an anesthetic, whereas esketamine acts on specific neural receptors to enhance brain plasticity. Due to potential side effects like sedation, Spravato is administered under the supervision of an approved healthcare provider like Marpa Minds.

Safety Profile of Spravato 

Spravato (esketamine) offers a new approach to treating treatment-resistant depression, but it’s natural to have questions about its safety. It is important to consider its potential side effects and how Spravato’s administration minimizes risks before you choose this treatment.

Side Effects of Spravato

Common side effects of Spravato treatment, experienced during and after administration, include dissociation, dizziness, nausea, sedation, spinning sensation, numbness, anxiety, lack of energy, increased blood pressure, vomiting, feeling drunk, and heightened feelings of happiness or excitement. These side effects typically manifest shortly after taking Spravato and typically dissipate within the same day.

Risk-free Spravato Administration

Spravato’s distinct administration approach reduces risks by ensuring treatment occurs in a controlled healthcare setting under professional supervision, unlike traditional ketamine. Administered as a nasal spray, Spravato minimizes the potential for misuse compared to injectable ketamine, mitigating risks associated with diversion for recreational purposes. Additionally, Spravato’s dosing is tailored to individual needs, closely monitored by healthcare providers to prevent over-medication and optimize efficacy. The limited dosing schedule, typically used in conjunction with other antidepressants, reduces the likelihood of dependence, offering a safer alternative for those with treatment-resistant depression.

Spravato Treatment Precautions 

Before using Spravato (esketamine) nasal spray, it’s important to take certain precautions:

  • Allergies
    Inform your doctor or pharmacist if you are allergic to esketamine, ketamine, or any other substances, as this product may contain inactive ingredients that could cause allergic reactions or other issues.
  • Medical History
    Disclose your medical history, particularly if you have a history of blood vessel problems, bleeding or increased pressure in the brain, high blood pressure, heart disease, stroke, liver disease, psychosis, or a personal or family history of substance use disorder.
  • Drowsiness and Dizziness
    Esketamine may cause dizziness or drowsiness. Avoid activities requiring alertness, such as driving or using machinery, until the effects have worn off. Limit alcohol consumption, as it can exacerbate these effects. 
  • Pregnancy and Breastfeeding
    Inform your doctor if you are pregnant or planning to become pregnant. Esketamine may harm an unborn baby, so reliable birth control should be used during treatment. If you become pregnant while using esketamine, discuss the risks and benefits with your doctor. Esketamine can also pass into breast milk and harm a nursing infant, so breastfeeding is not recommended while using this medication. 

It is important to consult your doctor or healthcare provider for personalized advice and guidance before starting your Spravato (esketamine) treatment.

What You Need to Know Before Getting Spravato Treatment

Before considering Spravato esketamine treatment, there are important factors to consider due to its novelty and strict regulation as a Schedule III substance. Unlike picking up a prescription from a pharmacy, obtaining Spravato treatment involves specific steps and considerations. Here’s what you need to know before undergoing esketamine treatment.

1. Your healthcare provider plays a very important role in ensuring your safety during your Spravato (esketamine) treatment.

As esketamine is psychoactive, causing temporary distortions in perception, it must be administered in a healthcare setting under direct medical supervision. Here’s how your healthcare provider ensures maximum safety during your appointment:

  • Pre-Appointment Research and Approval
    Psychiatrists stay updated on the latest research and FDA requirements for esketamine treatment. They ensure that esketamine is the appropriate treatment for you and handle any necessary paperwork.
  • Supervision
    While you administer the nasal spray yourself, your healthcare provider closely monitors the dosage and application process to ensure accuracy and proper functioning of the device.
  • Monitoring Time
    Your healthcare provider observes you for at least 2 hours post-treatment to monitor for any lingering psychoactive or disorienting effects. If effects persist, they may extend your supervision time.
  • On-Hand Staff
    While serious complications are rare, medical staff are available in case of adverse reactions or emergencies during treatment.
  • Guided Post-Treatment Care
    Many healthcare providers offering esketamine treatment partner with therapists or mental health professionals to provide comprehensive care. Your healthcare provider may refer you to a licensed therapist for therapy sessions to maximize treatment benefits and support your mental health journey.

2. Spravato (esketamine) must be taken with an oral antidepressant.

When prescribed Spravato (esketamine) for depression treatment, it’s important to note that it must be taken alongside an oral antidepressant. This requirement serves to bridge the gap between Spravato appointments, as the effects of the treatment can diminish over time. This gap can pose risks, particularly for individuals with severe depression. The oral antidepressant helps to mitigate symptoms between Spravato doses, providing continuous support. When used as directed and under proper medical supervision, Spravato can be a safe and effective treatment option for individuals with chronic or treatment-resistant depression.

3.  Spravato works differently than traditional antidepressants and may have a faster onset of action, but it’s not a first-line treatment.

Traditional antidepressants typically work by affecting the levels of brain chemicals like serotonin and norepinephrine. They may take weeks before you start to feel a noticeable improvement in mood. On the other hand, Spravato works differently, as it targets the glutamate system in the brain. This may offer a faster onset of action, with some people experiencing relief within hours.

However, Spravato is not a first-line treatment for depression.  It’s typically reserved for people with treatment-resistant depression, more specifically patients who haven’t found adequate relief with other medications and therapy.

Is Spravato (esketamine) Safe?

The answer is yes. Spravato (esketamine) nasal spray is safe when used proper medical supervision and with awareness of potential side effects. Having open communication with your healthcare provider about your medical history and any concerns is very important before starting Spravato therapy. They can assess your individual situation and determine if Spravato is the right treatment choice for you, considering both the potential benefits and risks.

Marpa Minds offers Spravato treatment in Westchester Country, providing patients with access to cutting-edge therapies tailored to their needs. Whether choosing Spravato or ketamine, it is crucial for patients to work closely with their healthcare providers to determine the best course of action for their individual circumstances.

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