Spravato (Esketamine)

Spravato (Esketamine) –

·       FDA-approved treatment for major depressive disorder (specifically for depression that has not responded well to antidepressants) since 2019

·       Administered via nasal spray

·       Covered by all commercial insurances and Medicare.

·       Requires in-office treatments:

o   Twice weekly for four weeks, then

o   Once weekly for four weeks, then

o   Continued weekly treatments or every other week treatments for maintenance

·       Individual treatment duration: 2 hours (nasal spray administered, then 2 hour monitoring period)

·       Restrictions: Cannot drive for rest of day after treatment

Pros:

·       One of the most effective treatments for depression that exists - 50% remission rate (depression resolved), 75% response rate (over 50% improvement)

·       Independently effective and reducing suicidal thoughts, aside from its profound effect in treating depression

·       Ketamine (although not spravato specifically) has been found to be very effective for treating not only depression, but also for anxiety disorders and PTSD.

·       Vast majority of side effects wash out completely within two hours) and no significant side effects thereafter. No long-term side effects.

·       Covered by insurance

Cons:

·       Maintenance treatment is required to maintain the benefit of the medication

·       Cannot drive for rest of the day after a treatment

Process:

·       Schedule consultation with our neuromodulation expert, Dr. Ahmed

·       If determined to be a good candidate, start treatment in about 2-3 weeks