Intranasal Esketamine ( Spravato) is approved by the FDA for Treatment-Resistant Major Depressive Disorder.
Patients who are still depressed after being treated with at least 2 different antidepressants at an adequate dose and for an adequate period of time are known to have treatment-resistant depression.
Spravato is available in the form of an inhaler. It’s delivered directly to our office by the specialty pharmacy when it is approved by the patient’s insurance. Spravato is not dispensed to patients by regular pharmacies because of its abuse potential.
Patients come in 2 times a week to our office in 1st month of treatment. They are required not to eat or drink for 2 hours before treatment and there is a restriction of certain medications like sedatives. We check their vitals and explain the use of this treatment and watch them self-administer the medication just like an asthma inhaler. It makes you little buzzed or may cause your BP to go up slightly. In some cases, the patient may even feel a little disoriented or have visual changes for a short period of time which resolves quickly.
Vitals are checked at regular intervals and patient status monitored.
After the treatment, you must have a ride to take you back to your home and you will need to take rest for the rest of the day.
In the 2nd month, you will come once a week and in 3rd month once in 2 weeks. In some cases, if your symptoms are not improving, we may increase your dose to achieve the desired results.
Some patients may need once a month visit for maintenance treatment.
Please call our office to schedule an appointment to see if you meet the criteria for treatment with Spravato.