What Is Spravato?
Spravato (esketamine) is an FDA-approved medication for treatment-resistant depression (TRD). Unlike traditional antidepressants, which primarily target serotonin, dopamine, and norepinephrine, Spravato works on the glutamate system by blocking NMDA receptors. This novel mechanism leads to rapid antidepressant effects, often within hours.
How Does Spravato Work?
Spravato is a nasal spray formulation of esketamine, a derivative of ketamine. By modulating glutamate neurotransmission, it enhances synaptic plasticity, which is crucial for mood regulation. Patients receiving Spravato often experience a dissociative state, which some describe as a dream-like or detached sensation.
Who Qualifies for Spravato Treatment?
Spravato is approved for adults with treatment-resistant depression, defined as major depressive disorder (MDD) that has not responded to at least two antidepressant trials. It is also approved for major depressive disorder with acute suicidal ideation.
Spravato Age Limit
Spravato is approved for adults only (18+). It is not currently indicated for children or adolescents.
Spravato Treatment Process
Spravato must be administered under medical supervision due to potential side effects.
- Induction Phase: Twice-weekly treatments for the first four weeks.
- Maintenance Phase: Weekly or biweekly treatments depending on response.
Patients must stay at the clinic for at least two hours post-administration to monitor for side effects.
Is Spravato Covered by Insurance?
Many insurance providers, including Aetna, Cigna, Tricare, Anthem, and Blue Cross Blue Shield, cover Spravato. However, coverage depends on specific Spravato REMS (Risk Evaluation and Mitigation Strategy) requirements, including monitoring and prior authorization.
Side Effects of Spravato
Common side effects include:
- Dissociation (feeling detached from reality)
- Increased blood pressure
- Nausea and vomiting
- Drowsiness
- Dizziness
- Bladder issues (rare)
Can Spravato Make Depression Worse?
Some patients report temporary worsening of symptoms after treatment. This effect is usually transient but should be discussed with a provider.
Spravato vs. Other Treatments
Spravato vs. Traditional Antidepressants
- Spravato works faster than SSRIs/SNRIs.
- It is administered under supervision, unlike daily oral medications.
Spravato vs. Ketamine Infusion
- Ketamine infusions are IV-administered, while Spravato is a nasal spray.
- Insurance often covers Spravato but not ketamine infusions.
- For a more comprehensive comparison, see this.
Spravato vs. TMS (Transcranial Magnetic Stimulation)
- TMS is non-invasive and has no dissociative side effects.
- Spravato works faster, while TMS requires 4–6 weeks of daily sessions.
Can You Take Spravato at Home?
No. Due to the risk of sedation and dissociation, Spravato must be administered in a certified healthcare setting.
Spravato and Alcohol
Avoid alcohol while using Spravato, as it can increase sedation and blood pressure effects.
Spravato and Adderall
There is limited research on interactions, but both medications can raise blood pressure and should be used cautiously together.
Spravato Treatment Reviews
Many patients report significant improvement in mood and suicidal thoughts after starting Spravato. Reviews on Reddit and other forums highlight both positive experiences and challenges, including cost and side effects.
Finding a Spravato Clinic Near You
If you are considering Spravato, search for “Spravato treatment near me” or check the official Janssen website to find certified providers.
Conclusion
Spravato represents a groundbreaking approach to depression treatment, particularly for those who have not responded to traditional medications. If you or a loved one struggles with treatment-resistant depression, call Cornerstone Psychiatric Care to schedule a consult at (561) 531-7818.