Spravato (Esketamine) for Depression
Spravato (Esketamine) is a fast-acting medication for severe depression. If medications and therapy haven’t worked well for you, Spravato may be the best next step!
What is Spravato?
Spravato is an esketamine nasal spray used to heal treatment-resistant depression and suicidal ideation.
If you’ve tried therapy and medication in the past, but still haven’t been able to heal your depression Spravato may be the next best step. Take our quick quiz to see if Spravato is the right medication for you!
How Does it Work?
Spravato works works differently than most antidepressants. The medication blocks an NMDA receptor to allow more glutamate to spread from neuron to neuron. Glutamate is important because it helps increase the growth of our neurons and improves brain plasticity (how much the neurons change and form new circuits).
This is especially helpful for patients with lingering depression as it can promote changes to the brain in a way that’s different from most anti-depressants.
Patients with treatment-resistant depression often are unable to fix the rigid brain circuitry needed to feel better. They get trapped in the same habits and harmful thoughts. Spravato frees the brain to grow and change, to truly recover.
What Does a Visit Look Like?
Spravato sessions typically take a little over two hours. Spravato can raise blood pressure and cause side effects like nausea, drowsiness, and an “out of body feeling.” Therefore, there is a necessary two hour monitoring period to ensure our patients are safe and supported throughout treatment. During most of that time, patients can use their phones, sleep, and talk with our staff. We often use a chunk of that time to allow for talk therapy with one of our clinicians.
We recommend not eating for 2 hours before treatment and not drinking for 30 minutes before treatment. Also, please make sure to arrange a ride home following treatment as patients will not be allowed to drive the remainder of the day following Spravato treatment. When patients get to the office, we take vitals to ensure the patient may safely take the first dose of Spravato.
Patients self-administer the Spravato nasal spray under medical supervision. They should expect to feel the immediate effects of the medication for about 40-minutes before winding down.
After two hours, the effects of Spravato should have worn off, and patients are free to go home. While the immediate effects dissipate quickly, patients should expect the anti-depressant effects of Spravato to last 4 or more days.
How to Get Started
- Schedule a free consultation with our Spravato team. We’ll answer any questions you may have about Spravato treatment and let you know if Spravato is the right treatment option for you! You can book your consultation here or call/text us at (212) 707-8662
- Run Benefits Investigation and Request Insurance Approval. We’ll take care of this for you after your consultation with our doctors and let you know when we can start treatment.
- Start treatment. It’s that easy! As soon as we get approval from your insurance, we can start treating you right away. The first treatment will use a lower dose of the medication to make sure you tolerate the treatment well before moving to the full dose the second treatment.
Most frequent questions and answers
This depends a lot on the specific person and case, but patients often begin to see results in as little as a few hours! Within two weeks, many patients will begin to see more substantial effects from Spravato
Spravato and TMS (Transcranial Magnetic Stimulation) both treat severe, treatment-resistant depression but in very different ways. Spravato works to increase glutamate and overall neural plasticity in the brain, while TMS works to repair the specific circuit linking the dorsolateral prefrontal cortex and a deeper brain region controlling emotion. Several studies are even beginning to look at these treatments together as their effects may complement each other to improve the chance of success. Spravato may make it easier for TMS to work by increasing the flexibility (plasticity) of the brain. Read more about TMS here.
Most major insurance companies approve Spravato to treat treatment-resistant depression and suicidal ideation. Even if our office doesn’t accept your individual insurance, we are often able to negotiate with insurance companies to treat you here. Please reach out to our office staff over text or a free consultation to learn more about your specific plan.
The most common side effects of Spravato include: drowsiness, dizziness, and dissociation (an “out of body” sensation), and temporary heightened blood pressure. Spravato can also cause nausea, anxiety, and other side effects.
While the effects of Spravato wear off by the time the 2-hour monitoring is complete, patients should not drive or operate heavy machinery until they get a full night’s rest.