This article will provide a comprehensive understanding of Spravato treatment for depression, covering what it involves, its duration, and what patients can expect during sessions, thus helping individuals make informed decisions about their mental health treatment options.
Treatment-resistant depression
Treatment-resistant depression is a subcategory of major depressive disorder, and it often manifests with suicidal ideation among those for whom two types of other antidepressant treatments, including SSRIs and SNRIs, have proven ineffective.
There is an increasing prevalence of treatment-resistant depression today and a need for new therapeutic approaches. One such approach is Spravato, a novel treatment based on ketamine.
This article will review Spravato’s depression treatment, answering questions like “What to do during Spravato treatment?” and “How long is Spravato treatment?” for those in need.
What is Spravato?
A prescription version of ketamine called esketamine (brand name Spravato) is administered via a nasal spray. This nasal spray received approval in 2019 by the FDA for use in patients with treatment-resistant depression.
Spravato is a prescription medicine that is used along with an antidepressant. Spravato is a nasal spray, but the antidepressants are taken by mouth to treat two conditions:
- Treatment-resistant depression (TRD) in adults
- Major depressive disorder (MDD) in adults presenting with suicidal thoughts or actions
Unlike other antidepressants which change levels of things like serotonin, Spravato or ketamine, actually changes the growth of synapses in the brain while also improving neural communication by restoring malfunctioning or dead glutamate receptors on the ends of neurotransmitters. All of this helps to improve communication and function in the brain, and by extension, change mood, decrease depression, and alleviate anxiety symptoms.
Spravato treatment process
Spravato is only available through restricted programs called Spravato REMS. Only healthcare facilities that are certified in this program can provide Spravato depression treatment. The programs offer outpatient services, so you don’t have to remain overnight.
The Spravato treatment process
While it is a nasal spray, Spravato must be provided under the supervision of a healthcare professional in a licensed clinic.
When you arrive for your session, you’ll be seated comfortably, and your healthcare provider will show you how to use the nasal spray device. They will tell you exactly how much to use and when to do it.
Your treatment schedule will be provided for you, and it’s something that you must adhere to.
Each time you arrive for your session, your healthcare provider will supervise you during and after you have used the device and let you know when it’s time for you to go.
Preparation steps before starting treatment
Before you start Spravato, you will need to inform your medical team about any and all medical conditions you have, including:
- Heart or brain problems
- History of stroke
- History of heart attack
- Hypertension
- Liver problems
- Psychosis
- You are pregnant, plan to become pregnant, or are nursing
Before you use Spravato, you’ll need to inform your healthcare provider about:
- Other medication you are on
- Over-the-counter medication you are using
- Vitamins you take
- Herbal supplements you use
It is especially important to inform anyone providing Spravato treatment if you are on:
- Central nervous system depressants
- Psychostimulants
- Monoamine oxidase inhibitors
If you are using any nasal corticosteroids or decongestant medicine, you need to take them at least one hour before your Spravato depression treatment.
Before Spravato treatment for depression, you should not eat for at least 2 hours, nor should you drink anything for at least 30 minutes beforehand.
How long is Spravato treatment?
The Spravato treatment process can last a few weeks. This is something that you will discuss with your healthcare provider before beginning treatment. Most cases assign patients an average of six doses administered over the course of two or three weeks.
The frequency of sessions over weeks or months is based on individual needs. When you meet with your healthcare provider for Spravato depression treatment, they will provide information on any follow-up care you might need, including the ongoing use of antidepressants or other behavioral therapy and the need for potential maintenance sessions as part of your long-term Spravato treatment for depression.
Activities during Spravato sessions
On the day of your treatment, your blood pressure will be taken beforehand and after you have used the nasal spray. As mentioned, you will administer the spray yourself, and for the next 2 hours, you’ll remain under observation to monitor any potential side effects.
What patients can expect to do during a treatment session
During your treatment session, it’s not uncommon to feel dissociative effects, with many patients having reported an immediate lightness or dissociation from their limbs. Some patients feel warmth, slight tingling, and immediate relief from depression symptoms.
Importance of supervision
Immediately after your treatment, you’ll still have to remain at the facility under supervision. During that time, the supervising healthcare provider checks for any side effects that could be dangerous.
Because there are reports of things like respiratory depression, sedation, and dissociation, you have to be monitored for at least 2 hours after you take Spravato by your healthcare provider. For that reason, you’ll have to remain at the center until you are told that you can go.
Restrictions or activities patients
There are some restrictions on your activities immediately before and after treatment. As mentioned, you have to avoid certain medications, eating, and drinking before.
Someone else has to drive you home after your appointments for Spravato treatment.
Following Spravato treatment, you cannot do any activity that would require you to be completely alert, operate machinery, or drive until the following day after you have had a good night’s sleep.
Efficacy of Spravato in treating depression
The FDA has approved Sparvato nasal spray to be used specifically in conjunction with an oral antidepressant.
This treatment has been evaluated in several short-term clinical trials and one longer-term trial. The short-term clinical trials spanning 4 weeks found that those who used Spravato had a statistically significant change in the severity of their depression symptoms, and for many of them this effect took place within two days. In the longer term trials, many patients achieved remission with continued Spravato treatment with statistically significant breaks in depressive symptoms before any relapse.
Summing Up
What is Spravato treatment? It is a novel approach that uses a nasal spray version of ketamine along with an oral antidepressant to provide treatment for those with treatment-resistant depression. The Spravato treatment process is fairly simple and short, with many patients only requiring a few sessions per week over the span of up to 4 weeks.
If you are struggling with major depressive disorder and treatment-resistant depression, there could be potential benefits in Spravato treatment for depression. Don’t be afraid to consult with healthcare professionals for personalized advice.