How Does Spravato Work?

How Does Spravato Work?

Spravato, also known as esketamine, is a medication approved by the United States Food and Drug Administration (FDA) in 2019 for the management of treatment-resistant depression. Spravato is typically used in conjunction with an oral antidepressant and is administered under the supervision of a healthcare provider.

What is Spravato?

Spravato is a nasal spray containing esketamine. It was approved by the US Food and Drug Administration (FDA) in 2019 as a treatment for depression that has not responded to other medications.

Spravato is only available through a restricted distribution program called the Spravato Risk Evaluation and Mitigation Strategy (REMS) program and can only be administered by a licensed healthcare provider in a certified clinic. A patient must also be monitored for two hours after the medication is administered, to ensure that there are no adverse reactions or side effects.

How Does Spravato Work?

Esketamine’s exact mechanism of action is not entirely understood. Esketamine is a form of ketamine, a dissociative anesthetic that is also being used in the clinical setting as an off-label treatment for depression, chronic pain, and other mental and physical health disorders.

Unlike traditional antidepressants, which work by increasing levels of serotonin or other neurotransmitters in the brain, ketamine’s mechanism of action is believed to involve increasing the levels and activity of a different neurotransmitter called glutamate.

Glutamate is the most abundant excitatory neurotransmitter in the brain and plays a vital role in pain processing and regulation of mood, cognition, and perception.

By increasing glutamate activity, ketamine is thought to stimulate the growth of new brain connections and promote the growth of new brain cells, a process known as neurogenesis. This may help to reverse or at least improve some of the changes in the brain that cause the development of chronic pain and mental illness. The antidepressant effect of esketamine or Spravato is also thought to be mediated by this mechanism.

Who is a Good Candidate for Spravato?

Spravato is strictly regulated and only approved for use in patients with treatment-resistant depression. To qualify for Spravato, a patient must have tried at least two different antidepressants without success.

As mentioned, it is typically used in combination with an oral antidepressant. It is important to note that Spravato is not a first-line treatment for depression and should only be considered after other treatment options have been exhausted.

Are There Any Potential Side Effects?

The most common side effects of Spravato include sedation, dissociation (a feeling of being disconnected from reality), confusion, dizziness, nausea, and vomiting. These side effects typically occur within two hours of taking the medication and resolve after several hours following treatment.

Final Thoughts

Spravato is an FDA-approved medication for the treatment of treatment-resistant depression. It was developed to leverage the successful off-label use of low-dose ketamine infusions to treat depression and other mental health conditions.

It is administered under the supervision of a healthcare provider in a certified clinic and should only be considered after other treatment options have been exhausted. Like ketamine infusion therapy, it offers many benefits, including rapid onset of action, high efficacy, and potential for sustained symptom relief.

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