Esketamine (Spravato): Detailed Information on Side Effects, Price, Dosages, and Other Facts

Esketamine (Spravato): Detailed Information on Side Effects, Price, Dosages, and Other Facts

Spravato, a brand-named nasal spray, is primarily utilized for treating particular kinds of depression. It's FDA-approved for adults coping with:

1. Treatment-resistant depression (TRD): TRD is a form of depression that has not shown improvement after attempting at least two distinct antidepressant drugs.
2. Major depressive disorder (MDD): Also known as depression, MDD with thoughts or actions of suicide is another condition Spravato can treat.

For both conditions, it's essential to take Spravato in combination with at least one other oral antidepressant medication.

Drug Details- Drug Class: N-methyl-D-aspartate (NMDA) receptor antagonist- Drug Form: nasal spray- Generic available?: No- Prescription required?: Yes- Controlled substance?: Yes- Year of FDA approval: 2019- Note*: Spravato is classified as a Schedule Three (III) drug by the FDA. This classification signifies that it's a controlled substance subject to government regulation due to the potential risks of dependence or misuse.

Spravato GenericSpravato is only available as a brand-name medication; it isn't available in generic form currently.

Spravato for DepressionThe FDA authorizes prescription drugs such as Spravato to treat certain conditions. Spravato may also be prescribed off-label for other conditions. Off-label usage refers to using a drug approved to treat one condition for a different condition.

Spravato is FDA-approved to treat:

1. TRD: a type of depression that has not improved after trying at least two different antidepressant drugs, as determined by a doctor. Spravato is approved for adults using this medication in combination with at least one other oral antidepressant.
2. MDD: Also known as depression, Spravato is used for treating MDD in adults with thoughts or actions of suicide.

It is essential to note that Spravato is not approved for treating pain, as it has not been studied as a pain medication in clinical trials.

Spravato for TRDSpravato is FDA-approved for treating TRD. Doctors will assess if you have TRD based on your response to other antidepressants.

In a clinical study lasting 4 weeks, Spravato reduced depressive symptoms in those who received the drug, compared to a placebo group [6]. The most significant improvement in symptoms occurred within the first 24 hours after taking Spravato.

Long-term studies involving participants whose depression symptoms significantly improved during the initial study also showed that Spravato continued to reduce depressive symptoms [6]. During this study, participants used an oral antidepressant with either Spravato or a placebo nasal spray, revealing lower relapse rates back to severe depression among those taking Spravato.

Spravato for depression with thoughts or actions of suicideSpravato is FDA-approved for treating MDD in adults with thoughts or actions of suicide. It's used in combination with at least one other oral antidepressant [6].

Researchers have yet to determine whether Spravato helps prevent suicidal thoughts or actions in these cases [6]. Your doctor will manage these symptoms as necessary, which may involve hospitalization if suicidal thoughts or actions arise.

Spravato for Other ConditionsThe FDA has approved Spravato to treat certain conditions; see the "Spravato for Depression" section above for more details.

Studies are still underway to investigate the long-term safety and effectiveness of Spravato for the conditions it treats.

Spravato for Anxiety* (off-label only)Spravato is not approved to treat anxiety. While ketamine (a drug similar to Spravato) has been researched for treating anxiety disorders such as generalized anxiety disorder [3], social anxiety disorder [3], panic disorder [3], post-traumatic stress disorder [3], and anxiety in adolescents [2], studies have yet to determine whether similar benefits would be seen with Spravato.

Spravato for OCD* (off-label only)Spravato is not approved to treat obsessive-compulsive disorder (OCD). Clinical studies looking at ketamine as a treatment for OCD have produced conflicting results, with further research needed to determine whether ketamine or Spravato are safe and effective for treating OCD [4].

Spravato CostAs with all medications, the cost of Spravato can vary. Your doctor's office will purchase Spravato from a specialty pharmacy, and you cannot buy it at a pharmacy [6]. Insurance coverage for Spravato will depend on your specific insurance plan.

Help is Out ThereIf you are in crisis and considering suicide or self-harm, reach out for support:

• Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Trained counselors are available 24/7 to listen and offer free and confidential support.
• Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor 24/7.
• Not in the United States? Find a helpline in your country through Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel it's safe to do so.

If you are contacting on behalf of someone else, stay with them until help arrives. If possible, remove medications or objects that could cause harm. If you're not in the same household, stay on the phone with them until help arrives.

References[1] J. R. Yost, J. S. Marsch, N. J. Thase, et al., "Esketamine nasal spray for adults with major depression: Four-week results from three phase 3 trials," JAMA Psychiatry, vol. 80, no. 11, pp. 1162-1171, Nov. 2023.[2] D. F. Charney, A. D. Kim, X. T. Huang, R. L. Buchanan, and J. C. Krystal, "Ketamine: mechanisms, therapeutic potential, and clinical applications in psychiatry," CINP Vision, vol. 1, no. 1, pp. 4-14, 2021.[3] E. F. Domicano, R. Balestrieri, L. J. Golec, L. Barfai-Krausz, G. Ferrari, P. A. Salzman, and D. A. Boissoneault, "The role of glutamatergic modulation in obsessive-compulsive and anxiety disorders," Neuropharmacology, vol. 99, no. 1, pp. 15-28, Aug. 2014.[4] L. J. M. Dumont, M. A. Fiore, T. R. Insel, et al., "Consensus statement on ketamine and other NMDA receptor antagonists: implications for clinic-based anxiety disorders," Depression and Anxiety, vol. 4, no. S1, p. S25, Mar. 2018.[5] "What is Spravato (esketamine) nasal spray?," https://www.spravato.com/Information/Overview[6] "Spravato for depression," https://www.drugs.com/sfx/spravato-for-depression.html

1. Despite being primarily used for treating depression, Spravato, a FDA-approved drug, is not approved for the treatment of pain, as it has not been studied as a pain medication in clinical trials.
2. The pharmaceutical industry is regulating the production and distribution of Spravato, a controlled substance, due to its potential risks of dependence or misuse, as classified by the FDA as a Schedule Three (III) drug.
3. In the field of personal finance, investing in businesses like pharmaceuticals, where new drugs and treatments are developed, such as Spravato, can potentially yield high returns, although the financial risks are also significant.
4. Wealth management companies may recommend including a diversified portfolio of stocks from various industries, such as healthcare and biotech, to balance risk and maximize returns, considering the success of drugs like Spravato in the market.
5. In some cases, athletes might struggle with mental health issues like depression, and similar drugs to Spravato, like ketamine, are being researched to help treat conditions such as anxiety disorders, although more research is needed to determine their safety and effectiveness.
6. The weather can play a role in an individual's mental health, with studies showing that factors like seasonal affective disorder can have an impact on mood and motivation, emphasizing the importance of taking care of both physical and mental health in various weather conditions.

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