Spravato / Esketamine

What’s the difference between Spravato and ketamine?

While both Spravato (esketamine) and ketamine are derived from the same basic chemical compound and are used to treat depression, there are several key differences between the two:

1. Chemical Composition: Ketamine is a racemic mixture, meaning it contains two mirror-image molecules: R-ketamine and S-ketamine. Spravato, on the other hand, is composed solely of S-ketamine, which is one of these two molecules. S-ketamine is considered to be more potent in its antidepressant effects.

2. FDA Approval and Indications: Spravato is specifically approved by the FDA for treatment-resistant depression (TRD) and depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior. Traditional ketamine, while used off-label for depression, is primarily approved as an anesthetic. Because of Spravato's FDA approval, insurance will pay for it.

3. Administration: Spravato is administered as a nasal spray under medical supervision in a clinical setting, ensuring that patients are monitored for side effects and efficacy. Ketamine, when used for depression, is typically given via intravenous (IV) infusion, also in a medical setting.

4. Dosage and Frequency: The dosing regimen for Spravato is standardized and involves specific protocols, including initial twice-weekly doses followed by maintenance doses. Ketamine infusion protocols can vary more widely depending on the clinic and the individual treatment plan.

5. Safety and Monitoring: Due to its approval and specific indications, Spravato treatment includes stringent safety and monitoring guidelines mandated by the FDA, including a Risk Evaluation and Mitigation Strategy (REMS). Ketamine treatment protocols can vary, and not all may have the same level of standardized safety measures.

6. Side Effects: While both treatments can have side effects such as dissociation, dizziness, and increased blood pressure, the side effect profile and patient experience can vary slightly due to the differences in administration and formulation.

These distinctions make Spravato a more controlled and standardized treatment option for those with treatment-resistant depression, offering an alternative for patients who have not responded to other therapies.

What to Expect

When you choose Spravato treatment at our clinic, here’s what you can expect:

1. Initial Consultation: Our team will conduct a thorough assessment to determine if Spravato is the right treatment for you. This includes a review of your medical history, current medications, and mental health evaluation.

2. Insurance Coverage: Our team will work tirelessly to submit documentation and prior authorization forms to get Spravato covered under your insurance. Our team is dedicated to make Spravato accessible and affordable for everybody.

3. Monitoring Period: Spravato is administered as a nasal spray in a comfortable and safe environment. Each session lasts two hours, during which you'll be monitored by our healthcare professionals to ensure your safety and comfort.

4. Follow-Up Appointments: Regular follow-up visits will be scheduled to assess your progress and make any necessary adjustments to your treatment plan.

5. Ongoing Support: Our team is committed to supporting you throughout your journey. We provide continuous monitoring and support to ensure you are getting the most benefit from the treatment.

Q&A Section

Q1: How does Spravato work?
Spravato targets NMDA receptors in the brain, which are thought to play a role in mood regulation and depression. It helps to rapidly reduce symptoms of depression by creating new neural connections.

Q2: Who is eligible for Spravato treatment?
Spravato is approved for adults with treatment-resistant depression who have not responded adequately to at least two different antidepressants. Your eligibility will be determined during your initial consultation.

Q3: What are the common side effects of Spravato?
Some common side effects include dizziness, dissociation, increased blood pressure, and nausea. These are typically monitored during and after each treatment session to ensure patient safety.

Q4: How often do I need to take Spravato?
The initial phase of treatment involves twice-weekly sessions for the first month, followed by weekly sessions in the second month. Maintenance therapy frequency will be based on individual response and medical advice.

Q5: Can I drive after receiving Spravato treatment?
A5: No, you should not drive or operate heavy machinery on the day of your treatment due to potential side effects such as dizziness and sedation. It's important to arrange transportation home from the clinic.

Q6: How soon will I feel the effects of Spravato?
Many patients begin to notice an improvement in their symptoms within hours to a few days after the first treatment. However, individual responses can vary, and ongoing sessions are typically needed to achieve and maintain the best results.

For more information or to schedule your initial consultation, please contact us today. Our team is here to help you find the right path to mental wellness.

Call Phoenix Pointe Psychiatry today to schedule a psychiatric evaluation for yourself or book an appointment online.