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If you have treatment-resistant depression (TRD), you could be a good candidate for a nasal spray treatment called Spravato®. Spravato is esketamine, a “cousin” of ketamine that absorbs quickly through the mucous membranes and has been found to be effective for some people with TRD.
At 2nd Chance Treatment Center, with practice locations in Phoenix and Litchfield Park, Arizona, our team of board-certified psychiatrists offers in-office Spravato treatment for patients diagnosed with TRD. In many cases, Spravato yields results much more quickly than other standard treatments for depression.
How an MDD diagnosis turns into a TRD diagnosis
The most abundant neurotransmitter in your brain is glutamate. Glutamate is critical for the production of gamma-aminobutyric acid (GABA). GABA deficits have been connected to major depressive disorder (MDD) and other depressive and mood disorders.
MDD is often managed with oral antidepressants that keep more serotonin, another abundant neurotransmitter, available in your brain. However, these selective serotonin reuptake inhibitors (SSRIs) don’t work well — or even at all — for some people. This can lead to a diagnosis of treatment-resistant depression, which is when esketamine may be prescribed.
How esketamine works
Esketamine increases levels of glutamate and GABA quickly and effectively, working across a broader number of brain cells than SSRIs. You’ll typically be prescribed Spravato at the same time as an oral antidepressant for optimal results.
The Spravato process
Your provider consults with you about your candidacy for Spravato before making your first treatment appointment. Most people prescribed Spravato have already tried at least two different antidepressants without significant results.
If you’re a candidate, you usually start treatment on a twice-weekly basis. We only provide Spravato treatment in our office, and you’ll need to stay for two hours after your treatment is administered while we observe you for any side effects.
The treatment itself is a simple nasal spray containing esketamine. We administer several sprays in each nostril to reach the approved dose. After your treatment, you’ll relax in comfort until two hours have passed.
Potential side effects
The most common side effects of Spravato include disassociation, dizziness, and drowsiness. You might also feel some mild nausea. We monitor you to make sure these effects, if they occur, pass before you leave. We also watch your blood pressure, as some people have temporary high pressure after using Spravato.
How long Sparavato takes to have an effect
Everyone is different in how they react to Spravato. However, many people say they feel better within just 24 hours after Spravato treatment. The usual course of treatment is twice weekly administration for about four weeks. At that point your provider will sit down with you and evaluate your progress.
Some people need to keep taking Spravato to maintain effects. Others find they don’t need Spravato anymore. We work with you to maintain your mental health and keep TRD from returning.
To learn more and discuss whether you’re a candidate for esketamine, call the 2nd Chance Treatment Center location near you, or make an appointment online.