Spravato

Jane Leu Rekas March 16, 2023



"Spravato is a brand-name prescription medication. It’s prescribed for adults with either of these conditions:

Spravato (esketamine) is an FDA-approved prescription nasal spray used to treat treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal ideation or behavior. It’s derived from ketamine, a medication originally developed as an anesthetic but now recognized for its rapid antidepressant effects.

How Does Spravato Work?
NMDA Receptor Antagonist: Unlike traditional antidepressants that target serotonin, norepinephrine, or dopamine, Spravato acts on the NMDA receptor (a glutamate receptor in the brain). By modulating glutamate, it promotes new neural connections and helps improve brain plasticity.
Rapid Action: Spravato can provide noticeable improvements in mood within hours to days, which is especially critical for those experiencing suicidal ideation.
Synaptic Growth: By enhancing glutamate transmission, Spravato encourages the brain to form new synaptic connections, which is thought to improve mood regulation and cognitive flexibility.

Benefits of Spravato
Fast-Acting Relief: Unlike traditional antidepressants that may take weeks to show effects, Spravato can produce significant improvements in depressive symptoms within 24 to 48 hours.
Effective for Treatment-Resistant Depression: Studies show that Spravato significantly improves outcomes for individuals who haven’t responded to at least two other antidepressants.
Reduces Suicidal Ideation: For individuals in crisis, Spravato can quickly alleviate intense suicidal thoughts, offering a critical option for immediate stabilization.
Neuroplasticity: By fostering the growth of new neural pathways, Spravato may promote long-term recovery in combination with psychotherapy and lifestyle changes.
Alternative Mechanism: For individuals who haven’t responded to traditional medications, Spravato’s unique mechanism offers a new avenue for symptom relief.
Treatment Process
Administered in a Clinical Setting: Due to potential side effects like sedation or dissociation, Spravato is administered in a supervised healthcare setting. Patients must stay for two hours for monitoring.
Dosing Schedule: Initial treatment typically involves twice-weekly dosing for the first four weeks, followed by weekly or biweekly maintenance doses.
Combination with Oral Antidepressants: Spravato is intended to be used alongside an oral antidepressant for optimal results.

Potential Side Effects
Dissociation (feeling disconnected from reality)
Dizziness
Nausea
Increased blood pressure
Sedation or fatigue
Most side effects resolve within hours after administration.

Who Might Benefit Most?
Individuals with treatment-resistant depression
Those experiencing acute suicidal thoughts
Patients seeking rapid symptom relief

Considerations
Due to its potential for abuse (as a ketamine derivative), Spravato is available only through a Risk Evaluation and Mitigation Strategy (REMS) program to ensure safe use.
It's not recommended for individuals with a history of psychosis, as dissociation symptoms may worsen.

 
Spravato offers a powerful option for individuals struggling with persistent depression that hasn’t improved with standard treatments. Its fast-acting nature and impact on suicidal ideation make it a valuable option for those in acute distress. However, it requires careful monitoring and should be combined with ongoing therapy and psychiatric care for best results.

Evolve Heath in Clackamas does ketamine nasal spray and takes medicare 

6400 SE Lake Rd Ste 142, Portland 

(503) 447-3285 

Achieve TMS in clackamas takes medicaid  

700 N Hayden Island Drive 

Suite 340-350 Portland 

Free Consultation: 877-269-5032 


Body Mind Spirit Success
How to be successful in a body, using energy psychology.
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Jane Leu Rekas, LCSW
Jane Leu Rekas

Posted by Jane Leu Rekas

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