Now Offering Spravato!
We are proud to be a certified Spravato® REMS (Risk Evaluation and Mitigation Strategy) treatment center!
Spravato® is a prescription medicine that is administered in combination with an oral antidepressant. Clinical research has shown remarkable results for the management of treatment-resistant depression and major depressive disorder in adults.
Spravato® shows significant promise in treating depression in conjunction with an oral antidepressant.
Because esketamine is a pseudo psychedelic treatment for depression, during your experience you may experience lucid dreaming, time distortion or nausea. Your Provider will assist you throughout your treatment.
Your blood pressure will be checked prior to your treatment starting, 40 minutes after it starts, and again before you leave.
After treatment, you may feel groggy or woozy. You may not drive after treatment, so you’ll need someone to drive you home.
Spravato® helped Nicole’s treatment-resistant
depression. Now, she’s resuming her education
and sharing her story.
Allison’s son tried many oral antidepressants
without relief. Now, because of Spravato®,
Allison’s son is starting to feel like himself again.
Spravato® can cause serious side effects, including:
Before you take Spravato®, tell your healthcare provider about all of your medical conditions, including if you:
Tell your healthcare provider right away if you become pregnant during treatment with SPRAVATO®.
If you are able to become pregnant, talk to your healthcare provider about methods to prevent pregnancy during treatment with SPRAVATO®.
Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking SPRAVATO® with certain medicine may cause side effects.
Especially tell your healthcare provider if you take central nervous system (CNS) depressants, psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicines. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine.
How will I take SPRAVATO®?
What should I avoid while taking SPRAVATO®?
Do not drive, operate machinery, or do anything where you need to be completely alert after taking SPRAVATO®. Do not take part in these activities until the next day following a restful sleep. See “What is the most important information I should know about SPRAVATO®?”
What are the possible side effects of SPRAVATO®?
SPRAVATO® may cause serious side effects including:
The most common side effects of SPRAVATO® when used along with an antidepressant taken by mouth include:
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If these common side effects occur, they usually happen right after taking SPRAVATO® and go away the same day.
These are not all the possible side effects of SPRAVATO®.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide for SPRAVATO® and discuss any questions you may have with your healthcare provider.
You will meet with our Care Coordinator virtually to discuss the process, collect your health history and verify your insurance benefits.
Once your insurance benefits are confirmed and all your intake forms are completed you are ready for your first appointment with your prescribing Provider.
Your first appointment will be in person with your prescribing Provider. Your Provider will discuss your Spravato treatment in further detail, review your health history, medication list and answer any last minute questions you may have.
Once all your questions are answered your Provider will enroll you in the REMS program and create a protocol specific to you.
You must arrive with a trusted adult that will drive you home after treatment. We recommend you wear comfortable clothing. We will provide you with pillows and a blanket, but if there is a specific comfort item you require, please bring it with you.
Your experience will last between 60-90 minutes, but you must remain at the clinic for two hours for monitoring.
Weeks 1 to 4: Spravato is administered twice a week for eight doses.
Weeks 5 to 8: Once weekly
Week 9 and after: Every 2 weeks or once weekly*
*Dosing frequency will be individualized to the least frequent dosing to maintain remission/respon
Patients seeking treatment with Spravato (esketamine) nasal spray should first arrange a consultation call with a care coordinator to discuss initial questions, concerns and insurance benefits.
Following the consultation, an office visit with a prescribing provider should be scheduled to review the patient’s medical history, medication list, and assess the risks involved with the treatment. During this first visit the provider will also map your treatment plan and scheduling with you.
Upon completion, the patient will be enrolled in the Spravato® REMS program to monitor any serious side effects that may occur during treatment. On the next visit, the patient can begin the Spravato treatment.
So, which is the best treatment for TRD or MDD, Spravato or IV ketamine? Ultimately, the decision will depend on a variety of factors, including the severity of the disorder, the patient’s medical history, and their financial situation. It is important to consult with a doctor to discuss which option is best for your individual needs.
Spravato is the only FDA approved option, and is often covered by insurance. This makes it the preferred choice for many people seeking treatment. It is administered twice a week, over the course of four weeks, with a follow–up appointment after the four weeks have passed. Spravato is a fast–acting treatment and can have positive effects on symptoms within hours.
Both Spravato and IV ketamine are administered by a medical professional in a medical setting, such as a clinic or hospital. IV ketamine is an off-label treatment for severe depression, and is usually administered in twice-weekly sessions for several weeks. It is also given to the patient intravenously, instead of through a nasal spray.
While IV ketamine is not FDA approved and is not typically covered by insurance, it is a highly effective treatment option, and patients can experience symptom relief within days.
Although you have the option to choose between ketamine infusions or Spravato® as a treatment- it is important to recognize which medication can be more beneficial when addressing specific diagnosis.
| KETAMINE IV INFUSION | SPRAVATO | |
| Administration | Ketamine is administered through an IV infusion over an hour. | Spravato is self-administered in two to three successive intranasal sprays administered in five-minute increments. |
| Dosage | The dose is determined by weight and titrated over the series of six infusions based on the patient’s comfort and vitals. | Spravato comes in two doses 56mg and 84mg. Your healthcare provider will select the appropriate dose based on your response to the treatment. |
| Bioavailability | The bioavailability of IV ketamine is 100%. | Esketamine has a bioavailability of approximately 50%. Things such as clogged nasal passages and swallowing part of the medication can affect the the bioavailability. |
| Administration Time-Frame | Ketamine is administered in six treatments over the course of two to four weeks. Maintenance infusions are often needed, and the frequency is individualized based on the response of the patient. | Weeks 1 to 4: Spravato is administered twice a week for eight doses. Weeks 5 to 8: Once weekly Week 9 and after: Every 2 weeks or once weekly* *Dosing frequency will be individualized to the least frequent dosing to maintain remission/response. |
| Medication Conjunction | Ketamine can be administered in conjunction or as a single treatment for clients with MDD. | Spravato must be given in conjunction with an oral antidepressant. |
Treatment Time | IV ketamine infusions last for an hour, but we recommend booking yourself for 90 minutes to give you time to recover. | Spravato is a minimum of 2 hours after the initial dose is administered. |
| Insurance Coverage | Currently, insurance does not pay for the cost of ketamine treatment. Your insurance provider may however reimburse you once treatment is received. | Your insurance may cover the cost of Spravato. Your responsibility could be as little as $10 for each dose. |
| Diagnosis Treated | Major Depressive Disorder Obsessive Disorders PTSD Anxiety Disorders Neuropathic pains | FDA approved for major depressive disorder |
SPRAVATO™ is a prescription medicine, used along with an antidepressant taken by mouth, for treatment-resistant depression (TRD) in adults.
SPRAVATO™ is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO™ is safe or effective as an anesthetic medicine.
It is not known if SPRAVATO™ is safe and effective in children.
With the success of ketamine seen across the nation the creation of an FDA approved treatment was inevitable. In 2019 a nasal spray, Esketamine also known as Spravato was approved for the treatment of TRD.
With the addition of this new medication patients now have the option to utilize either ketamine or esketamine treatments for their depression.
You will take SPRAVATO™ nasal spray yourself, under the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the SPRAVATO™ nasal spray device.
Your healthcare provider will tell you how much SPRAVATO™ you will take and when you will take it.
Follow your SPRAVATO™ treatment schedule exactly as your healthcare provider tells you to.
During and after each use of the SPRAVATO™ nasal spray device, you will be checked by a healthcare provider who will decide when you are ready to leave the healthcare setting.
You will need to plan for a caregiver or family member to drive you home after taking SPRAVATO™.
If you miss a SPRAVATO™ treatment, your healthcare provider may change your dose and treatment schedule.
Some people taking SPRAVATO™ get nausea and vomiting. You should not eat for at least 2 hours before taking SPRAVATO™ and not drink liquids at least 30 minutes before taking SPRAVATO™.
If you take a nasal corticosteroid or nasal decongestant medicine take these medicines at least 1 hour before taking SPRAVATO™.
SPRAVATO™ may cause serious side effects including:
The most common side effects of SPRAVATO™ when used along with an antidepressant taken by mouth include: dissociation, dizziness, nausea, sedation, spinning sensation, reduced sense of touch and sensation, anxiety, lack of energy, increased blood pressure, vomiting, and feeling drunk.
These are not all the possible side effects of SPRAVATO™.
Please refer to the manufacturer’s Prescribing Information and Medication Guide or visit www.SPRAVATO.com.
Spravato is more often than not covered by insurance providers; however, its always best to double check with your insurance company
Founded by Dr. Trevor Peck, M.D., Anesthesiologist, Nepenthe Wellness Center exists to offer cutting-edge healthcare treatments and wellness solutions.
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