The generic name of SPRAVATO is Esketamine. It came about as the result of decades in which researchers explored the role that glutamate (another neurotransmitter) plays with respect to mental health. Classic anti-depressants mainly act on neurotransmitters such as serotonin and norepinephrine. However, the limitations of these medications led researchers to explore other ways. Esketamine is one form of ketamine, an anesthetic once used recreationally. Though ketamine was originally developed as an anesthetic, in some studies it yielded rapid and robust antidepressant effects. This discovery laid the foundations for SPRAVATO, a nasal spray that exploits esketamine's antidepressant potential.
Its mode of action is unique in contrast to traditional antidepressants. It hits the glutamate system, more specifically at the N-methyl-D aspartate (NMDA) receptor. The NMDA receptor plays a central role in synaptic plasticity, the ability of synapses to become stronger or weaker over time. Mood disorders have been suggested to be due, in part at least, to dysregulation in synaptic plasticity.
SPRAVATO works by modulating the NMDA receptor, in an effort to restore synaptic plasticity and reduce depressive symptoms. Its rapid onset of action distinguishes it from traditional antidepressants, which may take weeks to show their results.
A nasal spray, SPRAVATO is administered by a healthcare professional. During the induction phase (several weeks) patients usually get sprayed twice a week. In the induction period, the frequency of administration may be gradually reduced to once a week or less depending on individual response. The treatment is not a cure for all; it works along with an oral antidepressant. This collaborative approach aims to take advantage of the therapeutic effects and deal with the maze that is treatment-resistant depression.
Clinical trials indicate that SPRAVATO is effective in treating TRD (Treatment Resistant Depression). Clinical trials have demonstrated that patients who had not responded to several commonly used anti-depressants improved significantly when treated with SPRAVATO. Also of particular note is the rapid onset, for patients with TRD typically suffer a great deal in having to wait around while waiting weeks for traditional antidepressants to take effect. In addition, SPRAVATO has been shown to be effective in reducing suicidal ideation an aspect of the treatment process that is especially important. Sometimes the ability to swiftly relieve these symptoms and thoughts of self-harm can become lifesaving and bring hope from despair.
Though SPRAVATO represents a substantial advance in the treatment of mental illness, there are also some considerations and possible risks that the patient might face.
One point worth noting is that the risk of dissociation and sedation means administration must take place under immediate supervision. After every administration, patients have to stay at the healthcare facility for a minimum of two hours ensuring their safety.
Ketamine also has a history as an illicit recreational drug, which raises the potential for abuse. This risk can be reduced by strict monitoring and controlled administration but still makes it an important consideration.
Another thing to ponder is cost. Because SPRAVATO is a rather new and targeted treatment, it may be more expensive than common antidepressants. Getting insurance coverage and financial assistance programs ensures that those who would benefit from the drug have access to it.
You can return to normal activities like working, driving, and other daily chores after the 2 hours of your treatment as well as observation. Any side effects associated with SPRAVATO will be taken care of by the administration during the monitoring period.