What Causes Mental Health Problems?
8 July
Spravato is an intranasal medication approved by the FDA for use in treatment-resistant depression. Treatment-resistant depression is defined as having tried antidepressant medications in the past or are currently taking antidepressants and your depression is not fully-controlled. Spravato is also indicated for major depression with suicidal thoughts or behaviors.
Pharmacologically-speaking, Spravato is a nonselective, noncompetitive inhibitor of the NMDA receptor, which leads to downstream release of glutamate. This release of glutamate activates a number of other processes that may be responsible for Spravato’s rapid acting antidepressive effects and can theoretically increase BDNF, which increases neuroplasticity.
From a broader perspective, Spravato allows for our minds to disassociate for 45 minutes to an hour and take our normal, day-to-day “operating system” off line and allow us to detach from the thoughts that may be holding us back. In what has been described as a dreamlike state, the rapid acting antidepressant effects of ketamine along with an increase in neuroplasticity can allow us to change the way we think.
Ketamine is actually a combination of 2 molecules, S-ketamine (esketamine) and R-ketamine (arketamine). Spravato is the S-ketamine part of ketamine (hence the name “esketamine”). There is significant data that indicates that esketamine may be more powerful than arketamine, but dosing, route of administration, and the setting in which the medication is administered along with other variables all affect the experience you have while being treated.
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Your provider will meet with you for an initial evaluation session prior to your first Spravato treatment session and go over the entire process, including what activities to participate in in the days before your treatment session, what to bring to the treatment session (a warm, cozy blanket, a pillow, anything that makes you feel safe and secure), and your provider will address any questions or concerns you may have.
You should not eat or drink 2 hours prior to the treatment session, and you will need to have transportation to and from your appointment. If transportation is a concern, contact our office for options for ride assistance.
Spravato is administered intra-nasally, much like a decongestant nasal spray. Treatments are offered in-office only and each treatment session is 2 hours; during the first portion of the session you can expect to feel the effects of the medication, the second half of the session allows you to relax and reflect on that experience.
The setting in which this type of medication is administered can affect your experience and the outcomes of treatment. We have created a private, comfortable and tranquil room for each indivi
dual patient, complete with large reclining chairs, soft lighting and noise-canceling headphone with soothing music (see photos, below). Our medical staff and your provider are available during your entire treatment session and we will check on you intermittently to ensure your comfort and safety. This safe space encourages self-reflection and openness to the process of healing, which is critical to achieving the best possible outcome from treatment.