Spravato Services
Spravato Esketamine Nasal Spray Treatment
Spravato is an esketamine nasal spray used at Andala® to treat a range of mental health conditions. FDA-approved for treating treatment-resistant depression, Spravato uses an intranasal spray version of esketamine, which has been used as an anesthetic in medical practice for decades. Spravato is administered in our outpatient clinics and is prescribed in tandem with an oral antidepressant.
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What is Spravato?
Esketamine nasal spray, also known as Spravato, is an FDA-approved intranasal spray that can be prescribed to help patients with treatment-resistant depression along with an antidepressant. Not only is Spravato potentially rapid-acting, but it is the first truly new mechanism for depression that has been approved by the FDA in over 60 years. This drug is intended to be used for people with major depression who have not responded well to at least two antidepressants. Andala providers may recommend prescribing Spravato as part of your treatment plan. Nasal esketamine is related to ketamine, a safe, FDA-approved anesthetic that has been effective in the treatment of depression when used off-label in low-dose ketamine infusion therapy.
Spravato for Treatment-Resistant Depression
Spravato can be taken alongside another antidepressant. The treatment is done in a clinic, where patients are monitored for a few hours after taking the spray. Spravato is an excellent option for those who have tried other treatments and have experienced no success. It is a new way to manage depression.
How Much Does Ketamine Cost?
The cost of ketamine treatment varies depending on which delivery method is used. Andala Health works with most insurance companies to provide the lowest rates. If insurance does not cover the treatment, affordable self-pay rates are available. The average cost of ketamine is:
*Insurance rates are subject to increase based on your individual copay, deductibles, and coinsurance. For accurate insurance coverage of ketamine, please call us at 1-210-783-0582 or fill out the online form below.
Spravato Treatment Schedule
Induction Phase
The dosing schedule for the first four weeks is an “induction” series of twice weekly treatments. The starting dose is 56 mg, which may be increased to the maximum dose of 84 mg as needed and tolerated for the second treatment and beyond. During this time, you will work with your Andala provider to determine the effectiveness of treatment and make adjustments to optimize the outcome.
Maintenance Phase
What to Expect During a Spravato Appointment
What Happens During Your First Treatment Session
Each Spravato treatment is self-administered in a certified clinical setting under the supervision of psychiatrists and psychiatric mental health nurse practitioners. The medication is self-administered to support patient agency and to ensure ideal timing between administration and inhalation of the medication. Please arrive for your first appointment about 15 minutes early. You will be taught by a provider how to administer the medicine yourself by spraying it into your nostrils. We want to make sure you are comfortable and answer any first-time questions.
During these treatment sessions you will be monitored by an Andala care provider for two hours after the Spravato has been administered for any possible side effects. After you leave Andala, avoid operating any motor vehicles or heavy machinery, engage in hazardous activities, or make significant business or personal decisions until the day after treatment.
Spravato Dosage & Administration
The dosing schedule for the first four weeks is an “induction” series of twice-weekly treatments. Self-administering Spravato is similar to administering an OTC nasal spray. The tip of a small bottle is inserted into the nasal cavity; the patient then inhales as they initiate the spray into the nose.
The starting dose is 56 mg, which may be increased to the maximum dose of 84 mg as needed and tolerated for the second treatment and beyond. During the second month, the frequency is reduced to weekly, and may then be reduced to less frequent treatment as clinically indicated.
Post-Treatment Monitoring
After each Spravato treatment, our Andala providers monitor patients for at least two hours in the office to ensure patient safety.
The most common side effects that a patient may experience after taking Spravato include dissociation, dizziness, nausea, sedation, and transiently increased blood pressure. Side effects are typically mild and rarely persist beyond the hours after treatment.
Post-Treatment Tips
After your first Spravato treatment, Andala encourages you to look for any unusual side effects after leaving the treatment center.
An increase in blood pressure may occur for up to 4 hours after taking Spravato. If you experience excessive depressive or suicidal thoughts, increased blood pressure beyond four hours, problems thinking clearly, or bladder problems, contact your psychiatrist immediately.
Ketamine Treatment Options at Andala Health
Spravato Esketamine Nasal Spray
Spravato Esketamine Nasal Spray is a medication administered nasally. It is a minimally invasive way to receive ketamine treatment. A medical professional prescribes Spravato, and patients self-administer the treatment in our clinic under medical supervision. Patients are monitored for up to two hours after administration.
IV Ketamine
IV (intravenous) Ketamine is one of the most common forms of ketamine therapy. It is administered directly into the vein through an IV line. This method allows the ketamine to enter the bloodstream quickly. IV Ketamine allows for precise dosing with fast effects. Patients who want immediate effects will find this to be a convenient option. IV Ketamine infusions are the preferred method for those who are new to ketamine therapy.
IM Ketamine
IM (Intramuscular) Ketamine is a form of ketamine that is injected into the muscle. Typically, IM Ketamine is administered to the shoulder. However, it can be administered into the thigh or buttock as well. Since it is injected into the muscle, the body absorbs it faster. The doses can also be monitored, making it easier to control the experience. IM and IV Ketamine shots are effective in treating symptoms of depression, anxiety, and many other health conditions.
KET+
Ket+ is a therapy that combines ketamine with other medicines to help reduce some of the common side effects of ketamine treatment. These medications include a low dose of an anti-anxiety medication (benzodiazepine) and an anti-nausea medication (ondansetron). The purpose of Ket+ is to help patients benefit from ketamine without experiencing significant discomfort. Ket+ is for patients who are new to ketamine therapy or those who are sensitive to its effects.
What are the Side Effects of Spravato?
The most common side effects that a patient may experience after taking Spravato include:
- Dissociation
- Dizziness
- Nausea
- Sedation
- Transiently increased blood pressure
Spravato FAQs
Does insurance cover Spravato?
Is Spravato FDA approved?
How can I prepare for my appointment?
If you’re about to have your first Spravato treatment at Andala, there are a few tips we recommend to all new Spravato patients:
- Patients undergoing Spravato treatment are not permitted to drive afterward. We encourage arranging a ride with a friend or loved one, or utilizing ride-share services like Uber or Lyft. For those opting for ride-shares, a waiver must be signed in the clinic prior to treatment.
- Try to get plenty of sleep the night before.
- Bring a book, headphones or something for entertainment during the post-treatment monitoring phase.
- Spravato, like all depression treatments, works best when combined with talk therapy.
Andala’s Reconnect Lounge is a comfortable space for patients to spend time reflecting and relaxing after administering Spravato under the supervision of a member of our care team.
How often do you take Spravato?
How often you take Spravato will depend on your particular treatment plan. Any patient taking Spravato should only do so under medical supervision. Generally, Spravato is administered two times a week during the first 30 days of treatment, then once a week during the next 30 days of treatment. Ongoing administration of Spravato may occur on a weekly basis or every two weeks, as clinically indicated.
Where can patients get Spravato?
The FDA has approved Spravato for administration under medical supervision at certain clinics. Patients can self-administer Spravato at Andala clinics or another certified Spravato treatment center, and only under the guidance and supervision of a health care professional.
How effective is Spravato?
Can Spravato Treat Anxiety?
What are Possible Drug Interactions with Spravato?
Possible Spravato interactions may include but are not limited to, psychostimulants (e.g., amphetamines, methylphenidate, modafinil, armodafinil) and monoamine oxidase inhibitors (MAOIs), which may increase blood pressure. Benzodiazepines, opioids, or alcohol may increase sedation and make the treatments.
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