SPRAVATO (Esketamine)

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SPRAVATO (Esketamine)

How does Spravato work?

Spravato (esketamine) is the world’s first prescription nasal spray used in cases of treatment-resistant depression. It is designed for use in conjunction with oral anti-depressant medications in adults with major depressive disorder and/or suicidal ideation. While it’s important to note Spravato is not a substitute for hospitalization, it may provide you with relief from your worst depressive symptoms.

How does Spravato improve depression?

While the precise workings of Spravato are not fully understood, it may work by blocking the neurotransmitter glutamate from binding to NMDA (N-methyl-D-aspartate) receptors. By doing so, the medication may better regulate communication amongst nerve cells, alleviating the symptoms of depression. More research is needed to determine the exact mechanisms by which this phenomenon occurs.

How long does Spravato last?

Your doctor will likely start you on a low dosage of Spravato and decide to raise the increment based on your response to the drug. Spravato treatment is conducted in two main stages: the induction phase and the maintenance phase.

During the induction phase, you’ll take Spravato twice a week. After four weeks, you’ll sit down for a consultation with your doctor. Depending on how the drug is impacting your body and your depression, you will decide whether to continue on to the maintenance phase or stop using the drug.

If you decide to proceed with the maintenance phase, you’ll continue to take the drug as recommended by your doctor. They will likely prescribe the lowest possible dosage that still provides you with relief from your symptoms. As symptoms begin to decrease, you and your doctor will then determine whether you should use Spravato on a long-term basis.

What happens if I miss a dose of Spravato?

If you miss a dose of Spravato, it's essential to contact your medical provider right away. They’ll be able to reschedule your appointment and get your treatment plan back on course. It’s important to maintain a regular, safe dosage schedule for your health.

How does Spravato administration work?

Although you’ll receive your Spravato dosage in a medical facility, your doctor will show you how to administer the dosage yourself. Under their supervision, you will first blow your nose to rid yourself of any congestion. Then, your doctor will provide you with the correct number of devices needed for administration, which will depend on the strength of your dosage. After reclining your head at a 45-degree angle, you will take the dose and allow your body to absorb the nasal spray. 

To ensure there are no issues with side effects, you will then be monitored for an additional two hours before being released. Remember to arrange transportation to and from your appointment, as you are not permitted to drive immediately after your dosage. You should be able to resume your normal daily activities, including driving, the day following treatment. Spravato is usually taken once or twice a week, but you and your doctor will decide on a schedule that works for you.

How much are Spravato treatments?

Your Spravato treatment plan will depend on your individual needs. Your insurance may cover the cost of treatment, but you’ll need to inquire with your insurance company for specific details about coverage. If you still have difficulty understanding insurance coverage or need financial help, you can contact the manufacturer of Spravato, Janssen. The manufacturer offers a program called Janssen CarePath that assists patients in navigating the financial aspect of treatment.

What are the side effects of Spravato?

Spravato, just like any other medication, may cause some side effects. These side effects can range from mild to severe, with some of the most common side effects being:

  • Anxiety
  • Dizziness
  • Nausea or vomiting
  • Numbness
  • Sedation

These are normal side effects that should subside in the hours and days following Spravato treatment. If they do not go away, or if you experience more serious side effects, like high blood pressure or cognitive impairment, be sure to contact your medical provider immediately.

Can Spravato be taken at home?

Because of potential side effects, abuse concerns, and other issues surrounding the Spravato medication, it is not currently approved for at-home usage. Currently, it must be administered at a certified medical facility by a trained healthcare provider.

References

MediLexicon International. Spravato: Uses, side effects, dosage, and more. Medical News Today. https://www.medicalnewstoday.com/articles/326038#how-it-works
SPRAVATO®. SPRAVATO® (esketamine). (2021, May 14). https://www.spravato.com/trd/faqs.

With Insurance

Behavioral Health

Your copay
Depending on insurance

Without Insurance

Behavioral Health

$240

Initial Visit

$99

Follow Up

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998. Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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Affordable –
with or without insurance

With Insurance

Behavioral Health

Your copay
Depending on insurance

Without Insurance

Behavioral Health

$240

Initial Visit

$99

Follow Up