Many oral antidepressants are thought to treat depression by enhancing levels of neurotransmitters in the brain that affect mood (serotonin, norepinephrine, and dopamine). Antidepressants come in several types, and each works differently. Patients suffering from depression often need to try multiple medications before finding the one that provides them with the best symptom relief and the fewest side effects.

Even with so many options, some people still don’t find relief from depression with antidepressants. In cases in which oral antidepressants are unsuccessful, Spravato can be an excellent treatment option. In contrast to currently available oral antidepressants, Spravato targets the N-methyl-D-aspartate (NMDA) receptor. Spravato’s exact mechanism is unknown.

With Spravato, adults suffering from TRD or MDD with suicidal thoughts or actions can be treated effectively. The active ingredient in Spravato is esketamine, which is derived from ketamine. Spravato affects the brain’s chemistry in a similar way to antidepressants.

However, it increases glutamate levels, a chemical messenger that stimulates nerve cells. The mechanism for how Spravato reduces depression symptoms isn’t completely understood but researchers believe glutamate levels increase, reactivating or creating new neural connections in the brain. Chronic depression causes the brain to lose vital connections, which prolongs the symptoms of depression. By restoring lost connections to the brain, Spravato improves mood. In contrast to antidepressants, which can take weeks to work, Spravato relieves symptoms almost immediately in many cases.

Our specialists determine whether you are a good candidate for Spravato. A person with TRD or MDD who has tried at least two traditional antidepressants without success may be a good candidate for Spravato.

The Spravato treatment takes place in an office setting. You will receive twice-weekly treatments during your first month of therapy. Treatment sessions will be held on a weekly basis in the following month. Afterward, you continue with weekly or biweekly treatments.

It takes seconds to install Spravato, but you need to monitor it at our office for two hours. After that, you should have someone drive you home and take it easy for the remainder of the day. You must continue to take your antidepressant medication while taking Spravato.

Each patient will receive a different dose of this medicine. You should follow the instructions on the label or those given by your doctor. You should not change your dose unless it has been prescribed by your doctor.

It depends on the strength of the medicine and how much you should take. Depending on the medical problem you are treating, the number of doses you take each day, the time allowed between doses, and the duration of time you take the medicine will also vary.

The cost of ketamine therapy will differ for each individual based on their unique needs in terms of quantity of doses and length of treatment. However, for two doses, average costs range between $590-$885. In some cases insurance coverage may be available for some of the costs associated with ketamine therapy, talk to your provider about whether that may apply to you.
 
Spravato comes pre-assembled in a nasal spray device. There are two sprays in each device – one for each nostril. Taking two sprays is equivalent to taking 28 mg of esketamine. Depending on your dose, there might be a need for more than one Spravato nasal spray device. The dosage frequency of Spravato can change over time, so you don’t need to use it every day. Two treatments per week are likely to be needed for the first four weeks after you begin using it. The decision to keep using Spravato should be made by you and your healthcare provider after four weeks.
 
Dr. Soroya Bacchus, M.D., at Psychiatry Unplugged gives confidential support and effective treatments to their clients to improve their mental health. We are conveniently located at 6801 Park Terrace, Suite 530B Los Angeles CA 90045. For more information, call us or book an appointment online. We serve patients from Los Angeles CA, Beverly Hills CA, Santa Monica CA, Encino CA, Pacific Palisades CA, and surrounding areas.