Spravato is a relatively new medication approved by the United States Food and Drug Administration (FDA) back in 2019 for managing treatment-resistant depression.
The active ingredient in Spravato, esketamine, is a derivative of ketamine. Ketamine has been used as an anesthetic for many years, but its antidepressant effects were only recently discovered. Below is an overview of the administration process, safety precautions, and possible side effects associated with Spravato.
Administration Requirements
Spravato must be administered under the close monitoring of a healthcare provider. The medication is available in the form of nasal spray and must be taken twice weekly in a doctor’s office or certified treatment center.
To help minimize the risk of side effects, patients should remain in the doctor’s office or treatment center for at least 2 hours after each dosing session for observation. You should not drive or operate heavy machinery afterward for at least 24 hours after each treatment session.
The Administration Process
The administration process for Spravato is fairly straightforward. You will be given a nasal spray bottle containing the medication at the doctor’s office. The spray should be inserted into one nostril while the patient is seated with the head inclined backward at least 45 degrees.
The next step is to press down the plunger at the bottom of the vial once to deliver half the dose of Spravato into the nasal cavity, with the opposite nostril closed to ensure the medication is not lost through exhalation. The spray vial has been calibrated to deliver the medication in two equal doses, one for each nostril.
The next step is to repeat the process with the opposite nostril. The patient should then remain seated with the head tilted back for at least two to five minutes to ensure the medication has been absorbed.
The initial dosage for treatment-resistant depression is 56 mg (28 mg per nostril) twice weekly for the first four weeks, followed by 56 or 84 mg per treatment session once a week for the next four weeks. After week 8, your provider may adjust the dose or frequency depending on your response to treatment. Most people receive 56 or 84 mg of Spravato per subsequent treatment session every two weeks.
Side Effects of Spravato
Like all medications, Spravato may cause side effects. Some common side effects include:
- Dizziness
- Nausea
- Headache
- Elevated blood pressure
- Disorientation or mild dissociation
- Confusion
These side effects typically dissipate within a few hours after administration. It is important to note that Spravato is a powerful medication with the potential for severe adverse effects if used incorrectly. As such, it is vital to follow your healthcare provider’s instructions and only administer the medication under professional supervision in a controlled medical setting.
Is Spravato a Stand-Alone Therapy?
Spravato is not intended to be used as a stand-alone therapy for the management of treatment-resistant depression. It should be used alongside oral antidepressants, psychotherapy, or both to maximize its therapeutic benefits.
As such, you should not discontinue the other medications you are currently taking without consulting your healthcare provider.
Final Thoughts
Spravato is an effective medication for the management of treatment-resistant depression, but it must be administered under close medical supervision in a controlled medical setting. If you have been prescribed Spravato, you should follow your healthcare provider’s instructions to ensure maximum safety and efficacy.
