Esketamine (Spravato)
Studied in adults with treatment-resistant depression and taken with a daily oral antidepressant
After 16 weeks of therapy, those patients who stayed on SPRAVATO™ did better than those who stopped therapy
Nasal spray you self-administer under the supervision of a healthcare professional
Greater reduction of depression symptoms at four weeks† (compared to those who received a placebo and oral antidepressant
Studied in adults with treatment-resistant depression and taken with a daily oral antidepressant
After you take SPRAVATO™, a healthcare professional will monitor you for at least two hours during the observation period for possible side effects.
Spravato
Nasal Esketamine
This treatment is for those with depression who have failed at least two antidepressants. Patients will be required to have someone drive them home and will need to stay in our office for two hours. The initial treatment consists of twice weekly treatments for four weeks and then treatment once weekly. Ongoing treatment is usually required, which is what we also see with IV ketamine. The long-term safety study showed that esketamine was generally tolerable, with no new safety signals with dosing up to 52 weeks.
Spravato, or nasal esketamine, is chemically similar to ketamine and is offered in a nasal spray version as an in office treatment. It is FDA approved and covered by insurance. We are excited to offer this treatment as an in network provider. It is a very affordable option for those with insurance who would like to try ketamine therapy.
Ketamine has been hailed as the most important advancement in the treatment of depression in the past 50 years. Ketamine works on the NMDA receptor and modulates glutamate instead of serotonin, norepinephrine, and dopamine like traditional antidepressants. It is thought to help restore nerve synaptic connections in brain cells in people with major depressive disorder. It also works faster than other antidepressants. Patients often report symptom improvement in days instead of weeks. Suicidality also often improves rapidly.
“We’ve always prided ourselves in offering the most advanced treatments to our patients.“Insurance coverage of esketamine will allow this life-saving treatment to be accessible to patients that need it. With one-third of those suffering from depression unable to respond to antidepressant medications, being able to provide relief to patients that are otherwise treatment resistant is a great opportunity.”
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What should I do first if I am interested in this treatment option?Please call our office at 856-399-1010 to schedule an evaluation. Please call your insurance company and ask if treatment with Spravato (esketamine) is covered. The manufacturer of Spravato (Janssen) also provides assistance for patients in determining insurance coverage and may also be able to provide some financial support for your treatment. Please call the Janssen CarePath Program at 844-777-2828
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What is the next step if I have insurance coverage for Spravato?Our office will schedule you for a detailed evaluation to determine whether Spravato (esketamine) is the best treatment for your case of TRD and also what other treatment options should be considered for you in that regard.
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What is the next step after my evaluation ?Your first treatment session for administration of the intranasal treatment with Spravato will be scheduled promptly if Spravato (esketamine) is the right treatment for you.
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What happens at the office during my visits for Spravato (esketamine) treatment?Each visit to the office for treatment will take about two and a half hours Spravato is administered in the doctor’s office. There is a 2 hour safety monitoring period. During this time your BP will be monitored. You will also be checked for any sedation and presence of any dissociative symptoms (feeling strange, disconnected transiently) or any other side effects. After 2 hours, if you are stable then you will then be discharged home. You will need somebody to drive you home after the treatment.
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What are the common side effects with Spravato (esketamine?)These include transient sedation, a possible rise in your blood pressure and feelings of dissociation (such feeling strange, disconnected or change in sense of time). These side effects may typically be present for the first 2 hours after taking the nasal spray of ketamine. For this reason you are monitored in the doctor’s office for a period of 2 hours after your dose of Spravato (esketamine). Such side effects if they occur typically go away the same day. During this time your blood pressure will be checked periodically and you will be assessed for the presence of any specific side effects. After 2 hours the doctor will assess you clinically to make sure you are safe to be discharged home.
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How often are the treatments?For the first 4 weeks you come in twice per week, each time for a two and a half hour visit. In the second month your visits are now once per week. After that treatments for long term maintenance with Spravato (esketamine) might be once per week or twice per month depending on your clinical course.
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How is payment for this treatment handled at this practice?We will work with your insurance company to cover this service
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What is the cost of the treatment?We accept most insurances and will try to get it authorized.
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Will I be covered for Spravato (esketamine) treatment if I have bipolar depression?Unfortunately, the answer here is no. The reason for this is that the FDA approval is only for major depression based on the research that has been done to date. Insurance companies will not pay for any treatments that are not FDA approved as it treats such treatments as “off label”.
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Can I take Spravato (esketamine) at home?This is prohibited by the FDA as ketamine has the potential to be abused and therefore lead to addiction. Therefore, administration is solely at the doctor’s office.