Blog Spravato

Spravato (generic name esketamine) is a medication that was approved by the U.S. Food and Drug Administration (FDA) in March 2019 for the treatment of treatment-resistant depression (TRD) in adults. It is administered as a nasal spray and is often used in combination with an oral antidepressant.

1. Treatment-Resistant Depression (TRD): Spravato is specifically indicated for people who have not responded adequately to at least two different antidepressant treatments in the current depressive episode.

2. Mechanism of Action: Spravato works differently from traditional antidepressants. It is a derivative of ketamine, which is an anesthetic and has been found to have rapid-acting antidepressant effects. The exact mechanism by which it works is not fully understood, but it is believed to involve the modulation of certain neurotransmitters in the brain.

3. Administration: Spravato is administered as a nasal spray, typically in a healthcare provider's office or clinic. Patients are monitored for a period after administration due to the potential for side effects, including dissociation and sedation.

4. Treatment Schedule: Initially, Spravato is administered twice a week for the first four weeks, then once a week for four weeks, and then the frequency may be adjusted based on the patient's response.

5. Side Effects: Common side effects of Spravato can include dissociation (feeling disconnected from reality), dizziness, nausea, and headache. It can also increase blood pressure, so patients need to be monitored for this. Due to the potential for dissociation, patients are advised not to drive on the day of treatment.

6. Effectiveness: Spravato has shown rapid-acting antidepressant effects in some individuals with TRD. It can provide relief from depressive symptoms within hours or days, compared to the weeks or months it may take for traditional antidepressants to work.

7. Long-Term Use: The long-term safety and efficacy of Spravato are still being studied, and it is generally recommended as a short-term treatment option for TRD. Some patients may transition to other treatments once their symptoms improve.

It's important to note that Spravato is not a first-line treatment for depression and is typically reserved for cases where other antidepressant treatments have been ineffective. The decision to use Spravato should be made by a healthcare provider after a thorough assessment of the patient's condition and consideration of potential benefits and risks. If you or someone you know is struggling with depression, it's essential to seek professional help and discuss treatment options with a healthcare provider.

Reviewed by Dr Mathews Thomas