Spravato (Esketamine)

Spravato is an antidepressant used to treat major depressive disorder (MDD) in adults. It is specifically indicated for patients who have not responded adequately to other antidepressant treatments.

• Treatment-resistant major depressive disorder: Used in combination with an oral antidepressant for patients who have not responded to at least two different antidepressants.
• Major depressive disorder with acute suicidal ideation or behavior: Used in combination with an oral antidepressant to rapidly reduce suicidal thoughts and behaviors in adults.

• Spravato works by antagonizing the NMDA receptor, which leads to increased synaptic glutamate release and downstream AMPA receptor activation. This mechanism results in rapid antidepressant effects, helping to alleviate symptoms of depression more quickly than traditional antidepressants.

Spravato, like all medications, can cause side effects. Common side effects include dizziness, nausea, and dissociation. More serious or rare side effects may include increased blood pressure, sedation, and cognitive changes.

Common Side Effects

• Dizziness: Feeling lightheaded or unsteady.
• Nausea: Feeling sick to your stomach.
• Dissociation: Feeling detached from reality or surroundings.
• Headache: Pain or discomfort in the head.
• Fatigue: Feeling tired or weak.
• Increased blood pressure: Elevated blood pressure readings.

Serious or Rare Side Effects

• Sedation: Excessive sleepiness or drowsiness.
• Cognitive changes: Difficulty with memory or attention.
• Increased blood pressure: Significant rise in blood pressure that may require monitoring.
• Abuse potential: Risk of misuse or dependence, especially in individuals with a history of substance abuse.

Spravato should be used with caution and under the supervision of a healthcare provider. It is important to follow the prescribed dosage and administration instructions to minimize risks.

• Administration: Must be administered under the supervision of a healthcare provider in a certified healthcare setting.
• Blood pressure monitoring: Regular monitoring of blood pressure is required due to the risk of elevated blood pressure.
• Sedation: Patients should avoid driving or operating heavy machinery until the effects of the medication are known.
• Substance abuse: Patients with a history of substance abuse should be monitored closely for signs of misuse.
• Pregnancy: The safety of Spravato during pregnancy has not been established. Consult a healthcare provider before use.
• Storage: Store at 2-8°C: Keep refrigerated, protect from light, do not freeze or shake.

Spravato can interact with other medications, which may affect its efficacy or increase the risk of side effects. It is important to inform your healthcare provider about all medications you are taking.

Major Interactions (Avoid)

• CNS depressants: Concurrent use with other central nervous system depressants can increase the risk of sedation and respiratory depression.
• MAO inhibitors: Concurrent use with monoamine oxidase inhibitors can increase the risk of hypertensive crisis.

Moderate Interactions (Monitor Closely)

• Antihypertensives: May require adjustment of antihypertensive medications due to the risk of elevated blood pressure.
• Antipsychotics: May increase the risk of sedation and cognitive impairment.
• Benzodiazepines: May increase the risk of sedation and respiratory depression.