Standard antidepressants work by increasing the levels of naturally occurring chemicals in your body, such as serotonin, dopamine, and norepinephrine, to enhance communication between brain cells. Esketamine, however, takes a different approach , although it follows the same pathway, it’s main focus is increasing glutamate levels, the most abundant chemical messenger in the brain. This leads to a greater impact, affecting more brain cells simultaneously.

As with any medication, there are potential side effects associated with Spravato treatment. These side effects typically diminish with each treatment as your body adjusts to esketamine. Common side effects may include nausea, drowsiness, headaches, dizziness, feelings of intoxication, and increased blood pressure. For more detailed information on potential contraindications or side effects, please refer to the Medication Guide linked at the bottom of the page.

Some patients may also experience more severe side effects, such as hallucinations and a sense of disconnection from themselves and their surroundings. Due to these potential risks, it is crucial that Spravato treatment is administered in a safe and controlled environment where the patient can be closely monitored.

For the first four weeks, you can expect to come into the office twice weekly for treatment. During weeks 5 to 8 of treatment, you can expect to come in once weekly. For week 9 and after, the patient and their provider will decide if they should remain weekly or titrate down to biweekly.

Patients in the Spravato program should expect to be at the office for a minimum of two hours on a treatment day. You will have your blood pressure taken prior to administration, halfway through treatment, and then one last time at the end. Staff will monitor you throughout your treatment period. Patients will need to have a ride home from treatment and should not drive or operate heavy machinery until having a restful night’s sleep.

Spravato is given as a spray through the nose. Each device contains 1 spray for each nostril and contains a total of 28mg of Spravato. The dose for Spravato is 56mg for the first treatment; after that, you and your provider may decide whether to continue with the 56mg dose or to increase to 84mg.