Esketamine is a new medication that has been approved by the FDA for the treatment of treatment refractory depression (TRD). It is an intranasal spray that is typically used in combination with an oral antidepressant for adults who have not responded well to other treatments for depression. Esketamine works by targeting specific receptors in the brain that are involved in mood regulation, and it has been shown to have a rapid onset of action compared to traditional antidepressants. This medication has been found to be effective in reducing symptoms of depression and improving overall mood in those who have not found relief from other treatment options. However, it is important to note that esketamine should only be used under the supervision of a healthcare professional and is an in-office treatment that will require 2 hour monitoring with need for a ride as client will not be able to drive for entire day (before and after appointment).
There will be ups and downs, but the trend will be an increase in your baseline mood gradually. This change can be subtle and can take time to see appreciable changes.
The starting dose is 56mg dose (2 nasal sprays). We will assess for any side effect during treatment at this dose for the first week before moving up to the 84mg dose (3 nasal sprays) or staying at 56mg dose.
You must remain on concurrent antidepressant therapy while receiving Spravato treatment. This treatment has not been approved by the FDA as solo therapy. Accordingly, patients are strongly recommended to continue antidepressant therapy in order to gain full effect from Spravato treatment.
The dosing schedule is as follows:
There may be a dip in mood as you transition to once a week treatment, however, your mood will even out with time and continue to see progress.
Spravato is contraindicated with pregnancy and women of childbearing age should be on contraception or be sure not to get pregnant while receiving Spravto therapy.
Dissociation during treatment is not necessary for the success of Spravato Treatment