When depression continues despite treatment, it can be difficult to know what to try next. At Paradigm Psychiatry, we offer personalized evaluations to explore whether SPRAVATO® may be appropriate for you.
What is Spravato?
SPRAVATO® (esketamine) is an FDA-approved prescription nasal spray for adults with treatment-resistant depression. It may be prescribed alone or with an oral antidepressant.
Treatment takes place in our office under medical supervision. SPRAVATO® is not a take-home medication and is different from IV ketamine or compounded ketamine
Who may benefit?
SPRAVATO® may be an option for adults whose depression has not improved enough after trying at least two different antidepressants at appropriate doses and for an adequate length of time.
It is also FDA-approved, alongside an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who are experiencing acute suicidal thoughts or behaviors. However, SPRAVATO® has not been shown to prevent suicide or reduce suicidal thoughts or behaviors, and it does not replace emergency care or hospitalization when needed.
Your provider will review your symptoms, treatment history, and medical conditions to determine whether SPRAVATO® is appropriate for you.
How does it work?
Glutamate is a chemical messenger that helps brain cells communicate. It plays an important role in mood, learning, and memory.
SPRAVATO® temporarily blocks NMDA (N-methyl-D-aspartate) receptors, one type of receptor that responds to glutamate. Research suggests this changes glutamate activity and increases signaling through another receptor called AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid). These changes may support neuroplasticity—the brain’s ability to strengthen and form connections between nerve cells.
This differs from many traditional antidepressants, which primarily affect serotonin and/or norepinephrine. The exact way SPRAVATO® produces its antidepressant effects is not fully understood.
What to expect:
- 01You will use the nasal spray under the direct supervision of a healthcare professional, followed by at least two hours of monitoring.
- 02Throughout the two hour rest period, a safe and comfortable room is provided for you to take a moment to relax. Our team will monitor your blood pressure, breathing, oxygen level, and overrall response.
- 03Arrange a ride home after every session. You cannot drive or perform activities requiring full alertness until the next day.
- 04Response varies. Your provider will review your progress and adjust your treatment plan as needed.
Important Safety Information
SPRAVATO® can cause sleepiness, dizziness, nausea, increased blood pressure, and temporary feelings of disconnection. Serious risks include sedation, breathing suppression, and abuse or misuse. Antidepressants carry warnings about increased suicidal thoughts and behaviors in children and young adults; SPRAVATO® is not approved for children.
Treatment is provided through the restricted SPRAVATO® REMS safety program. Your provider will review your medical history, risks, and the Medication Guide with you.
Heads up!
Transportation
Please arrange a ride to and from the office. Do not drive or perform activities requiring full alertness until the following day after restful sleep.
