Spravato Nasal Spray for Treatment-Resistant Depression: A Guide from Cary Behavioral Health

At Cary Behavioral Health, we understand that treating depression can be challenging, especially for those who haven’t found relief through traditional antidepressants. For individuals with treatment-resistant depression (TRD) or major depressive disorder (MDD) with suicidal thoughts or actions, Spravato® (esketamine) nasal spray is an innovative option that may offer new hope. Here’s everything you need to know about this breakthrough treatment, how it works, and what to expect.

What is Spravato®?

Spravato® is a prescription nasal spray, used alongside an oral antidepressant, specifically for adults diagnosed with TRD and MDD with suicidal ideation. Unlike typical antidepressants that may take weeks or months to show results, Spravato® can have a faster impact on depressive symptoms.

How Does Spravato® Work?

Spravato® contains esketamine, which is chemically related to ketamine, a drug that has been used for decades in anesthesia. However, esketamine works differently from traditional antidepressants by targeting the brain’s glutamate system, which helps regulate mood. This novel mechanism of action can provide relief when other medications have not been effective.

What to Tell Your Healthcare Provider Before Starting Spravato®

Before starting Spravato®, it’s crucial to discuss your complete medical history with your provider. Be sure to mention:

  • Any history of substance abuse (whether prescription drugs, alcohol, or street drugs)
  • Any medical conditions, including heart, brain, liver, or mental health concerns
  • If you are pregnant, planning to become pregnant, or breastfeeding
  • All medications you’re currently taking, including over-the-counter drugs and supplements

You should not take Spravato® if you have:

  • A blood vessel disease such as an aneurysm
  • A history of bleeding in the brain
  • A condition known as an arteriovenous malformation (an abnormal connection between blood vessels)
  • Allergies to esketamine, ketamine, or any ingredients in Spravato®

The Treatment Process: What to Expect

Spravato® is administered in a certified healthcare setting, such as Cary Behavioral Health. It is not a take-home medication, and you will be closely monitored by a healthcare professional during each session. Here’s what happens during treatment:

  1. Administration: You’ll self-administer the nasal spray under medical supervision.
  2. Observation: After the spray, you’ll be monitored for at least two hours to check for potential side effects such as dizziness, dissociation, or increased blood pressure.
  3. Post-treatment: Because Spravato® can impair your ability to drive or operate machinery, you’ll need to arrange transportation home after each session.

Frequently Asked Questions (FAQs)

How is Spravato® different from ketamine infusions?
While both contain similar active ingredients, Spravato® is FDA-approved for TRD and MDD with suicidal thoughts and is administered via nasal spray, making it more accessible than intravenous ketamine infusions.

Can I take Spravato® on my own?
No. Spravato® must be administered in a certified healthcare facility where you’ll be monitored for safety.

Can I use Spravato® during pregnancy or while breastfeeding?
Spravato® is not recommended during pregnancy or breastfeeding. If you’re pregnant or planning to become pregnant, consult your healthcare provider about alternative treatments.

How do I know if Spravato® is working?
Improvements in mood may be noticeable after a few sessions. Your healthcare provider will assess your progress regularly to ensure Spravato® is effectively managing your symptoms.

What happens if I miss a treatment?
If you miss a session, your healthcare provider may adjust your dose or treatment schedule. It’s essential to stick to the prescribed schedule for optimal results.

Are there any restrictions on food or drink before treatment?
Yes. To minimize nausea, avoid eating for at least two hours and drinking liquids for 30 minutes before your treatment.

Potential Side Effects

As with any medication, Spravato® can cause side effects. The most common include:

  • Dizziness or a “spinning” sensation
  • Nausea
  • Sleepiness
  • Feeling disconnected from yourself or your surroundings
  • Increased blood pressure

Most side effects occur shortly after administration and resolve within a few hours. Your healthcare provider will monitor you to ensure your safety.

Important Safety Information

  • Sedation and dissociation: Spravato® may cause sleepiness, fainting, and dissociation (a feeling of detachment from yourself or your surroundings). You will be monitored for at least two hours after each dose to ensure you’re safe before leaving the healthcare setting.
  • Respiratory concerns: In rare cases, Spravato® may cause breathing issues. Your healthcare provider will track your oxygen levels and other vital signs.
  • Abuse and misuse: Esketamine, like ketamine, carries a risk of abuse and dependence. Your healthcare provider will screen for any history of substance abuse before and during treatment.

Managing Depression Beyond Spravato®

While Spravato® can be a valuable part of your treatment plan, it’s essential to take a holistic approach to managing depression. This may include therapy, lifestyle changes such as exercise, and other medications. Cary Behavioral Health offers comprehensive mental health services to support your overall well-being.

Conclusion

Spravato® nasal spray offers hope for individuals struggling with treatment-resistant depression or severe depressive symptoms. At Cary Behavioral Health, our certified team is here to guide you through every step of the process, ensuring that your treatment is safe and effective. If you’re interested in learning more about whether Spravato® is right for you, contact us today to schedule a consultation.

For more information, download the Spravato® Patient Brochure and Discussion Guide to help prepare for your appointment.

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