Spravato(Esketamine) For Depression at Farhat Medical Clinic

Ketamine is a controlled substance, used for decades in Anesthesia and recently in Psychiatry, to provide rapid improvement for symptoms of depression, without the delayed onset or side-effects of traditional antidepressants.

Ketamine is a revolutionary new treatment for depression. It works quickly and has minimal side effects compared to other current treatments. It was traditionally done as an Intravenous infusion which required extensive monitoring and expense. A newer intr-nasal treatment route called Esketamine allows for lower doses, making the process safer and more accessible . 

Spravato is a NMDA receptor antagonist, meaning it helps restore neural connections that may be weakened due to prolonged depression. By enhancing synaptic plasticity, Spravato can lead to rapid improvements in mood, cognition, and overall mental well-being. Many patients experience significant relief within hours to days after starting treatment, making it an innovative option for those who have not responded to conventional medications.

Administered as a nasal spray under medical supervision, Spravato is paired with an oral antidepressant to maximize effectiveness. Patients remain in clinic for monitoring after each session to ensure safety and comfort.

Yes, most insurances in the state of West Virginia cover Spravato (Esketamine) treatment. 

The Spravato labeling contains a Boxed Warning that cautions that patients are at risk for sedation and difficulty with attention, judgment and thinking (dissociation), abuse and misuse, and suicidal thoughts and behaviors after administration of the drug. Other side effects include but are not limited to Dissociation, Dizziness, Nausea, Sedation, Vertigo, Headache, Dysgeusia, Hypoesthesia, Anxiety, Lethargy, Blood pressure increased, Vomiting, Insomnia, and Diarrhea. I also understand the potential side effects form Spravato nasal treatment may include: Nasal discomfort, throat irritation, feeling drunk, dry mouth, hyperhidrosis (sweating), euphoric mood, dysarthria, tremor, oropharyngeal pain, mental impairment, constipation, pollakiuria, feeling abnormal, tachycardia (elevated heart rate), abuse, misuse, and physiological dependence 

Spravato is contraindicated in patients with the following conditions:

• Aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels) or arteriovenous malformation

• History of intracerebral hemorrhage

• Hypersensitivity to esketamine, ketamine, or any of the excipients. 

• Two treatments per week (typically on non-consecutive days).
• This phase is designed to provide rapid symptom relief as the medication begins working to restore synaptic connections in the brain.

• One treatment per week
• Patients who experience positive response during the induction phase transition to weekly sessions, allowing for continued improvement and symptom management.

• One treatment every 1-2 weeks, based on individual response and provider recommendations.
• The frequency of treatment is adjusted to maintain symptom relief while ensuring long-term benefits.

Each session lasts approximately two hours, during which patients are monitored for safety and side effects.