OBHI is a certified spravato center

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.

Major depressive disorder affects one in 15 adults in the United States and it is also the most commonly diagnosed mental health disorder associated with suicide. People with major depressive disorder may have suicidal thoughts and these can be triggered in a very short period. Hence, immediate and effective treatment is recommended for MDD.

What is MDD?

Major Depressive Disorder, also known as clinical depression is a serious form of mental health disorder that affects the way you feel, think, and negatively impacts your daily and normal life. Symptoms include:

1. Feeling depressed
2. Sleeping too much or too less
3. Changes in eating habits - eating too little or too much
4. Loss of interest in activities that you enjoyed earlier
5. Feeling lonely, angry, or irritated without a reason
6. Unable to concentrate
7. Difficulty in taking decisions
8. Violent thoughts or behavior
9. Suicidal thoughts

How does esketamine work?

Esketamine Spravato is the nasal spray prescribed to treat MDD and TRD(Treatment-Resistant Depression). Patients who do not respond to antidepressants are diagnosed with TRD (Treatment-Resistant Depression). Abnormalities in glutamatergic transmission and lower levels of neurotransmitters are known to be one of the many causes of depression and other mental health illnesses. Antidepressants help in increasing the levels of neurotransmitters like serotonin, norepinephrine, and dopamine. But Esketamine helps in regulating the levels of glutamate which immensely helps in improving the symptoms of depression. It also acts faster compared to antidepressants. Esketamine proved to be immensely helpful and successful in improving depressive symptoms and reducing suicidal thoughts within hours. It is a powerful antidepressant medication that helps in improving the depressive symptoms right from the first session of the treatment.

Risk factors of esketamine

People may experience disassociation, drowsiness, nausea, dizziness, hypoesthesia, distress, tiredness, elevated blood pressure during the treatment. You will need to be at the doctor's office for 2 hours to make sure that you don't have any significant side effects and you are stable to leave. You might experience lightheadedness or dizziness even after 2 hours. Hence someone has to accompany you to drive you back home after the treatment.

Who benefits from Esketamine Treatment?

Patients diagnosed with the following mental health disorders can get symptom relief with the help of Esketamine Spravato Treatment:

1. Major Depressive Disorder
2. MDD with Suicidal thoughts
3. Treatment-resistant depression

Certified Spravato Treatment Center in Massachusetts

Intranasal Esketamine Treatment has to be carried out only in a Spravato Certified Treatment Center. We are a certified Spravato Center in Massachusetts, having a dedicated team with experience and expertise in treating patients using Esketamine Spravato. Talk to us or book an appointment to know if Spravato Treatment is right for you.

Esketamine is approved by the FDA and is a nasal spray medication for treatment-resistant depression. This nasal spray is available only at a certified doctor's office or clinic.

Treatment-resistant depression (TRD):

Treatment-resistant depression is diagnosed in patients who do not find relief from depressive symptoms even after taking antidepressants or undergoing psychotherapies.

A person has to be diagnosed with treatment-resistant depression only after a thorough assessment by the doctor. It is reported that one-third of people with depression experience major depressive disorders with symptoms like prolonged sleeplessness or suicidal thoughts.

Esketamine Spravato's role in treating TRD:

While oral antidepressants can take several weeks to bring in noticeable changes in depressive symptoms, Esketamine shows the effect in a few hours. Esketamine is self-administered by the patient in the form of a nasal spray under the supervision of a doctor at the doctor’s office. You might have to stay in the doctor's for 2-3 hours after receiving Esketamine, for the healthcare provider to monitor any side effects.

Esketamine is not a new medicine in the market. It is made from Ketamine, which has been used to treat depression. Esketamine was approved by the FDA only in 2019 and has been used extensively in conjunction with oral antidepressants to treat patients with major depressive disorders and TRD.

Lower levels of neurotransmitters are said to be one of the causes of depression. Though oral antidepressants help in increasing the levels of these chemical substances, Esketamine targets the chemical substance "glutamate" which is responsible for making more active and new connections, thereby reducing symptoms of depression more effectively than other oral antidepressants.

Side effects of Esketamine:

Side effects of esketamine include anxiety, dissociation of thoughts, sleepiness, nausea, lethargy, or increased blood pressure. Severe side effects include suicidal thoughts or extreme changes in behavior. You need to get immediate medical attention in case you notice severe side effects. Your doctor will closely monitor you for any side effects that you experience after taking the Esketamine nasal spray.

How effective is Esketamine?

Though there might be side effects, in cases where the benefits outweigh the side effects, Esketamine is recommended. Compared to patients only under oral antidepressants, patients who underwent Ketamine treatment in conjunction with oral medications noticed a significant reduction in depressive symptoms within four weeks. Also, it is recommended to continue the Esketamine Spravato treatment since there are better results on patients who continued the treatment versus the patients who discontinued.

Are there any patients who are at risk and are not advised to use the Ketamine nasal spray?

Expecting mothers, patients with high blood pressure or poorly controlled heart diseases are not recommended to take Esketamine. Your doctor will discuss other viable treatment options if you fall under a high-risk category and refrain you from undergoing treatment using Esketamine. You also need to discuss any other medications that you are currently taking for any other diseases like epilepsy, depression, or anxiety.

Other treatment options:

Though Esketamine comes as a relief for people with major depressive disorders and TRD, it might not be recommended to women who are pregnant, children, or people who are under medications that might interfere with Esketamine. There are other treatment options like ECT (Electroconvulsive therapy), rTMS (Transcranial Magnetic Stimulation) that are safe, FDA approved, and proved to efficiently treat depression and other mental illnesses.

TMS for You, understands and treats every patient differently and we make sure that the best treatment option is provided considering the patient's medical health. We are an expert team of psychiatrists with vetted experience in helping people with different mental health conditions. Please feel free to book an appointment or avail of our telemedicine services.