Reclaim Your Life with Spravato Esketamine Nasal Spray

Spravato esketamine nasal spray is the only FDA-approved form of ketamine treatment for both depression and suicidal ideation. Spravato can help alleviate ongoing clinical depression when traditional medications haven’t worked.

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Spravato: Esketamine For Depression

Spravato treatments are an effective alternative to traditional SSRIs for individuals suffering from Treatment-Resistant Depression and Major Depressive Disorder, with or without acute suicidal ideation. It is unique in that it is the only form of ketamine that is FDA-approved for a mood disorder and can be fully covered by insurance. If you’re thinking about starting esketamine treatment at Bespoke, we will evaluate you thoroughly and devise the right treatment plan‌ made for you.

Traditional antidepressant medications require months to fully take effect and often are accompanied by undesirable side effects. Esketamine works faster and lasts longer, with some patients noticing a difference after the first session. Our team has been administering Spravato since 2020, so we have years of experience helping people through major depression utilizing alternative and safe methodologies.

What is Spravato?

Spravato is the brand name for an esketamine nasal spray that helps people find relief from treatment-resistant depression. Esketamine is a chemical that consists of two mirror-image molecules, S-ketamine (esketamine) and R-ketamine (arketamine). When used as an anesthetic or in an intravenous infusion, both the S and R mirror images are included. However, Spravato is solely esketamine alone in a nasal spray bottle.

Spravato REMS: A Comprehensive Summary

When Spravato was approved in 2019, the FDA mandated it be part of a Risk Evaluation and Mitigation Strategy (REMS) Program. This means that all providers, facilities, and pharmacies working with the drug must be certified by REMS before ordering or storing Spravato. The REMS program has strict criteria in terms of the Spravato dosing protocol, storage requirements, and patient tracking. Spravato REMS dictates that patients are not allowed to take the medication home under any circumstances; the medication must be stored in a safe, DEA-compliant manner at the provider’s facility. The REMS program mandates that patients maintain an oral antidepressant prescription along with Spravato. Finally, the REMS program mandates that all Spravato patients are required to stay in the office for a minimum of 2 hours for safety purposes. Patients must enroll in the REMS program before Spravato is administered. Fear not; our administrative team will carefully walk you through the REMS process and ensure that registration is quick and painless.

Spravato vs Ketamine vs Esketamine

In the United States, Spravato and esketamine can be used interchangeably; Spravato is simply the brand name for the nasal spray form of esketamine manufactured by Janssen. In other countries, esketamine might be available in the form of an infusion–just like ketamine now. The jury is still out when it comes to ketamine vs esketamine: when administration is standardized, most studies demonstrate comparable efficacy. For some patients with a naturally high tolerance to ketamine’s antidepressant effects, the Spravato dosing schedule might feel limiting. However, we’ve unearthed additional medication that seems to increase the efficacy of Spravato without increasing the dosage.

Bespoke Treatment has overseen hundreds of sessions involving both Spravato and generic ketamine nasal spray, made by compound pharmacies. We have found Spravato to be much more consistent and effective than compounded ketamine nasal spray, and as such, we have stopped prescribing ketamine nasal spray completely in favor of Spravato. It’s reported that esketamine has fewer dissociation-related side effects compared to ketamine. Additionally, we see positive results for both ketamine and Spravato for anxiety, although it’s important to note that we can only prescribe Spravato for a primary diagnosis of Major Depressive Disorder, Bipolar Depression, or Suicidal Ideation.

How Does Spravato Work?

In clinical trials, patients who take Spravato show a reduction in depression symptoms even within the first 24 hours. Just like generic ketamine, Spravato acts on your brain’s NMDA receptors, allowing it to work faster than traditional SSRIs and create lasting change in your neural pathways. It is also commonly used to enhance talk therapy, known as ketamine-assisted therapy (or in this case, esketamine-assisted therapy). 

 Spravato Dosing Schedule

Spravato REMS has a strict dosing schedule that providers and patients must adhere to. For depression, the initial dosage is always 56mg. As long as 56mg is well tolerated, patients are to increase to 84mg for all subsequent sessions. For patients with primary suicidal ideation, the protocol is to start and remain at 84mg for all sessions. For the first month (dubbed the “Induction Period”), patients self-administer Spravato twice per week on non-consecutive days. After your first month, you’ll meet with your psychiatrist or specialist and assess your progress. During the second month, patients start tapering: one session on week 5, one session on week 6, and then one session between weeks 7 and 8. At the end of the second month, you’ll meet with your provider again to determine your maintenance schedule. For some, a maintenance schedule might be one session per week. For others, it could be one session per 3 months. It’s impossible to truly assess what the maintenance schedule of Spravato will be until we start tapering.

Spravato Treatment Reviews

In almost all cases, Spravato is prescribed for patients who have tried other types of medication and therapy without success. Because it is FDA-approved, some insurance companies may cover Spravato. Most patients report positive benefits from esketamine treatment, but it’s not the right treatment for everyone. We see remission from depression consistently with Spravato and our data suggests that it is comparable to ketamine infusions.

 What should I expect while using Spravato?

Bespoke Treatment offers Spravato as an in-office treatment only. However, before starting any treatment, we conduct a comprehensive evaluation to ensure that this is the best possible option for you. We will show you how to self-administer the nasal spray and you’ll be afforded a private, comfortable room designed for psychedelic therapy. You’ll also be given an eye mask, iPod, and luxurious noise-canceling headphones to best support your 2-hour journey each session.

Spravato Side Effects & Safety

Esketamine can trigger some initial and short-lived side effects such as dizziness, floating sensations, or mild hallucinations like ketamine and other psychedelics. You can rest comfortably at Bespoke Treatment knowing that you’ll always be under the supervision of a licensed provider for your entire session. Our team will always make sure to check your blood pressure mid-session to make sure that you’re safe and don’t require any additional medication. When your provider discharges you towards the end of the session, you will need a friend or family member to drive you home. You may be tired for the rest of the day, but any fatigue will pass by the time you wake up the next morning. Unlike most traditional antidepressants, Spravato doesn’t seem to cause weight gain.

Should I Do Esketamine For Depression?

Spravato might be a good treatment option for you if conventional treatments for depression haven’t relieved your symptoms, and you are in good physical health. If you have a history of substance abuse, your provider may recommend an alternative such as Transcranial Magnetic Stimulation (TMS) first.

Is Spravato covered by Insurance?

Whereas ketamine sessions can range from $400-$550 per session depending on location, one Spravato session might only be a $20 copay in comparison. Spravato is typically covered by most major insurance policies as long as you’ve tried at least 2 antidepressants in the past. If you’re wondering the price of Spravato for your insurance plan, don’t hesitate to reach out. We will happily let you know what your copay would look like, if any.

Take the First Step Towards Relief From Treatment-Resistant Depression

If you reside in Los Angeles, Las Vegas, or Santa Monica and are considering Spravato nasal spray for depression treatment, don’t hesitate to reach out to our mental health professionals to get your personalized treatment plan.

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