The U.S. Food and Drug Administration approved Spravato (esketamine) nasal spray, in conjunction with an oral antidepressant, for the treatment of depression in adults who have tried other antidepressant medicines but have not benefited from them (treatment-resistant depression).
Esketamine is made from a drug called ketamine, an anesthetic that has also been used for many years to treat depression. But it wasn’t until recently that esketamine, a more potent version of ketamine, earned FDA approval specifically for use as a nasal spray for those with treatment-resistant depression.
With the nasal spray, you give yourself three doses, spaced five minutes apart, under provider supervision. You remain in the clinic under provider observation until potential side effects have passed.
Esketamine must be used in conjunction with a conventional antidepressant. The intention is that esketamine provides rapid relief from depression symptoms until the other medication takes effect.
Usually, the treatment is given twice a week for the first month, and then if it is successful it is continued at decreased frequency in a maintenance phase for a few weeks or months with dosing and frequency determined by treatment response. Typically, this might mean a decrease to weekly treatments, then every two weeks, then monthly, etc.
You and your provider will discuss recommendations.
Esketamine works in a similar fashion, but unlike other antidepressants it increases levels of glutamate, the most abundant chemical messenger in the brain. The result? A greater impact on more brain cells at one time.
Common antidepressants are slow-acting. It often takes several weeks to make a noticeable difference in how people with depression feel, says Kaplin. On the other hand, esketamine immediately impacts brain cells, offering relief from depressive symptoms within hours.
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What is Ketamine Treatment?
Ketamine is a relatively new and innovative psychiatric/psychological treatment approach, involving ketamine administration in a safe and supportive setting.
The exact nature of the treatment process varies depending on the particular problems being treated and the specific individual’s needs and goals. Initial sessions will involve an evaluation of a patient’s: current problems, concerns, and needs; prior history and review of current or ongoing treatment; overall health/medical condition; and an assessment of the potential suitability and viability of this type of treatment for that patient. By the end of the evaluation period, we will offer our clinical impressions and a recommended approach to treatment. These goals will be reviewed during the course of the treatment in order to assess and/or modify them according to changing needs, perspectives, and progress.
If you are a current patient in the practice, your current medication provider may already make this treatment recommendation and we may already have all the history needed to begin treatment approach.
Why ketamine?
Current treatments for depression including medication usually have a 40% success rate. To make matters worse these medications do not reduce suicidal thoughts. They must be taken daily and cause unwanted weight gain and other ongoing side effects. This is a time consuming and frustrating process for depressed patients. By contrast, ketamine treatment can reduce or eliminate suicidal thoughts, often immediately. It treats depression rapidly, with no ongoing side effects.
With ketamine, the effects are more robust than with medications. Ketamine is about 70% effective, it also helps patients with more than just their mood and depression, it seems to help them start over and reconnect with who they are.
Call or text our office for more information 720-458-5413
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