Despite extensive efforts to combat depression through medications and psychotherapy, depression rates continue to soar year after year.
It is estimated that more than 264 million people suffer from depression worldwide. Of them, only 33 percent respond to available treatment modalities. Statistics support the efficacy of treatment modalities such as antidepressants. Depressed patients often lose hope when they experience no relief from antidepressants. Some even experience an increase in depressive symptoms.
Fortunately, a new form of treatment-resistant depression has emerged. Spravato (esketamine) is widely considered the most significant breakthrough in the battle against depression since the FDA approval of Prozac in 1987.
Let’s dive deeper into defining ketamine and esketamine. We’ll also discuss how it can help those who haven’t had success with standard treatment modalities.
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What Is Ketamine?
Ketamine was initially used as an anesthetic in the 1960s. It was used to sedate soldiers in the Vietnam war during this time.
Soon after, ketamine became a popular street drug due to its euphoric effects. Common street names included K, Special K, and Kit Kat.
Today, ketamine is FDA-approved for the treatment of depression. Numerous studies have demonstrated the efficacy of ketamine on treatment-resistant depression. One study found that nearly 70 percent of patients experienced a relief in depressive symptoms after four weeks on Spravato.
Ketamine is administered through a slow, intravenous (IV) drip. Over the course of two hours, it produces a therapeutic and calming effect on brain regions that control behavior and mood.
What Is Esketamine?
To understand Esketamine, you must first understand the chemical composition of ketamine. Ketamine is made up of two molecules, R-ketamine and S-Ketamine.
Although these two molecules mirror each other, they can’t be superimposed. Consequently, they bind with different receptors of the brain.
If you have treatment-resistive depression, your psychiatrist may recommend Spravato (esketamine). Unlike ketamine infusions, Spravato is a nasal spray containing only the S-ketamine molecule.
Benefits of Spravato Nasal Spray
There are plenty of attractive qualities that make Spravato worth considering. Some of the more prominent benefits include:
- The convenience of being a nose spray rather than an injection
- It only takes several hours to start working
- It’s a medication for anxiety and depression alike
- Works for adults with treatment-resistant depression
- It can help reduce suicidal thoughts
- It is more potent than ketamine, allowing doctors to give lower doses and avoid potential side effects
How Does Spravato Work?
Spravato treats depression by affecting one of the most common neurotransmitters of the brain, glutamate.
Glutamate is the primary neurotransmitter that makes neurons more active. GABA, another major neurotransmitter, tends to shut neurons down.
Glutamate is in approximately half of all connections in the brain. At high doses, ketamine blocks glutamate and has a sedative effect. This is why it’s used as an anesthetic.
On the other hand, low doses of ketamine increase glutamate production. Results can vary, but many individuals feel an alleviation of stress and a sense of peace. Some users report a shift in perspective, helping them conceptualize their problems objectively.
Ketamine can also help neurons grow new connections. Unfortunately, depression can lead to a loss in connections between neurons over time. Fortunately, ketamine can reverse years of damage caused by stress and depression.
Potential Side Effects of Spravato
The most severe side effect of using Spravato is the risk of abuse. There’s also a chance that Spravato may increase suicidal thoughts and behavior.
Most side effects occur during treatment sessions. Typically, these side effects will subside at the end of the session. Some of the most common side effects include:
- Lack of energy
- Feelings of elevated euphoria
- Vomiting and nausea
- Feelings of disassociation
Due to the risk of nausea and vomiting, you should avoid eating two hours prior to your appointment. You should also avoid drinking 30 minutes beforehand.
How Is Spravato Administered?
Spravato can only be administered at a certified clinic in a healthcare setting. Your healthcare provider will teach you how to use the spray bottle device.
It’s crucial to take Spravato as directed by your healthcare provider. Missing a treatment may result in your healthcare provider altering your dose or treatment schedule. It may also delay results.
Once you’ve administered the nasal spray, you will then wait until your healthcare provider determines you are safe to leave. You will then need a family member or friend to drive you home after your treatment session.
Who Is Eligible to Receive Spravato?
Despite FDA approval, not everyone is eligible to take Spravato. The drug is intended for adults with treatment-resistant depression. Patients must have tried at least two other antidepressants with no success.
Patients must also be taking another antidepressant medication in combination with Spravato. It’s also a good idea to undergo cognitive behavioral therapy during this time.
If you suffer from major depressive disorder and have suicidal thoughts or actions, you can bypass these requirements.
Get Your Life Back With Spravato
More than 3 million Americans are diagnosed with depression each year. Current predictions indicate that depression will be the leading cause of disease within the next decade.
Having anxiety and depression can feel like a constant weight on your shoulders. You’re numb, fatigued, unproductive, and it feels impossible to see an end to it.
If you’ve tried antidepressants with little to no success, Spravato may be the cure you’ve been looking for. Many studies have demonstrated the efficacy of Spravato on treatment-resistant depression.
Here at Basepoint Psychiatry, we’ve seen numerous patients experience relief through Spravato treatments. We’re confident that we can develop a tailored treatment plan to improve your depression.