Holistic Psychiatry LLC
Vijay Amarendran, MD
12 Acme Road, Suite 102 Brewer, ME 04412
PH: 207 - 299 - 1997
Fax: 207 - 387 - 2828
Esketamine nasal Spray (Spravato)
An FDA approved medication for treatment resistant depression.
What is Spravato?
Spravato (Intranasal Esketamine) is an FDA approved for adults with treatment resistant depression and in patients with Major Depressive Disorder (MDD) with suicidal ideations in an in-patient setting. It typically provides relief from symptoms within a few days from starting treatment. Spravato may not work in everyone who takes this medication. Spravato reduces depression symptoms in about 70% of the patients who try it. We do weekly treatments to start and then adjusting frequency based on response and this has worked well for the vast majority of our patients. Spravato is approved for use only in conjunction with another oral antidepressant at this time. Spravato is not a substitute for other antidepressant treatments such as medications and psychotherapy and it is highly recommended that patients continue their other antidepressant treatments.
Risks of Spravato
Sedation
Dissociation
Respiratory Depression
Abuse and Misuse
(Because of the risks of serious adverse outcomes resulting from sedation, dissociation, respiratory depression, abuse and misuse, SPRAVATO is only available through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the SPRAVATO REMS)
In addition it also can cause nausea, vomiting, anxiety and panic reactions, unsteady gait, dizziness, elevated blood pressure and drug high sensation.
Restrictions
Spravato can only be administered in a healthcare facility and requires a minimum of 2 hours of observation after dosing. Our clinic is required to monitor blood pressure, oxygen saturation and side effects at regular intervals. The patient will need someone to take them home from the facility after treatment and the patient cannot drive until the day after treatment. All patients will need to be registered with Janssen’s Food and Drug Administration (FDA) mandated Risk Evaluation and Mitigation Strategies (REMS) program prior to their first treatment.