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Therapeutic Infusions

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Spravato® Treatment

At Therapeutic Infusions, we offer advanced Ketamine Infusion Therapy and Spravato® (esketamine) for treatment-resistant depression and PTSD, providing expert care and renewed hope when traditional therapies haven’t worked.

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FDA-Approved Care, Delivered in a REMS-Certified Medical Setting

Therapeutic Infusions offers Spravato® (esketamine) in a calm, supportive environment designed around patient safety and comfort. Treatments are provided on-site in accordance with FDA REMS requirements, with medical supervision and monitoring throughout each visit.

REMS Certification & Why It Matters

Spravato® is provided under a special FDA safety program called REMS (Risk Evaluation and Mitigation Strategy). This program exists to make sure Spravato is administered in a setting that prioritizes patient safety, supervision, and follow-up care.

Because of these requirements, Spravato® can only be given in a REMS-certified healthcare clinic, where patients are monitored on-site after each treatment. Therapeutic Infusions meets all REMS standards and is authorized to provide Spravato® in a medically supervised environment.

REMS-certified care means:

  • Spravato is administered only in an authorized medical clinic
  • Patients are observed on-site for a minimum of two hours after treatment
  • Blood pressure, mental status, and overall stability are monitored
  • Treatment is overseen by trained medical professionals
  • Documentation and follow-up meet FDA requirements

What is Spravato?

Spravato® (esketamine) is an FDA-approved nasal spray used alongside oral antidepressants to treat adults with treatment-resistant depression. It contains esketamine, a more potent form of ketamine, which works by targeting the NMDA receptors in the brain, leading to rapid and significant improvements in mood and depressive symptoms. Administered under medical supervision in a healthcare setting, Spravato requires close post-treatment monitoring due to potential side effects. It offers a novel treatment option for those who haven’t found relief with other depression therapies.

Benefits of Spravato

  • Rapid reduction in depressive symptoms.
  • Effectiveness in treatment-resistant depression.
  • Improvement in mood and emotional well-being.
  • Potential reduction in suicidal thoughts in specific cases.
  • Quick onset of action compared to traditional antidepressants.
  • Provides an alternative for those who haven’t responded to other treatments.
  • FDA approval makes the treatment eligible for insurance coverage.

Understanding Treatment-Resistant Depression

Treatment-resistant depression (TRD) is a form of major depressive disorder (MDD) that doesn’t respond to traditional antidepressant medications. Patients with TRD often experience persistent, debilitating symptoms despite trying multiple treatments. Spravato is a relatively new and exciting treatment option that can offer hope in such cases. Spravato, administered as a nasal spray, works differently from conventional antidepressants by targeting the NMDA receptors in the brain. This can result in a rapid improvement in depressive symptoms, even in those who have struggled with TRD.

How Spravato Works

Spravato (esketamine) is administered via a nasal spray, entering the brain through the olfactory bulbs and targeting the N-methyl-D-aspartate (NMDA) receptor, a key player in mood and thought regulation. Unlike traditional antidepressants that focus on the serotonin system, esketamine acts on the NMDA receptors, leading to rapid improvement in depressive symptoms, particularly for those with treatment-resistant depression (TRD).

Spravato affects neurons that use glutamate to communicate, specifically acting at the synapse. GABA neurons, which inhibit glutamate neurons, may cause traditional antidepressants to fail for some TRD patients. Spravato is believed to block the NMDA receptor on GABA neurons, allowing the release of glutamate. This, in turn, stimulates AMPA receptors on receiving neurons, causing calcium influx and the release of brain-derived neurotrophic factor (BDNF). BDNF promotes neuronal growth and strengthens connections, offering a potential explanation for Spravato’s unique ability to help patients move past depressive patterns of thought and feeling.

What Does Spravato Treatment Look Like?

Before Your Appointment

Because Spravato® is administered under the FDA’s REMS safety program, patients receive specific preparation instructions and are treated in a certified healthcare setting. All patients will undergo a thorough medical history review and screening to ensure safety and efficacy before starting treatment. Generally, to prepare for your session, avoid eating for 6 hours and drinking liquids for 2 hours before your appointment. Follow all medication instructions provided, taking or skipping them as directed on the day of your treatment. Refrain from using cannabis on the day of your session and limit alcohol consumption beforehand. Arrange for transportation home, as driving is not recommended due to possible side effects like dizziness. For your comfort, bring a blanket if you prefer your own, headphones, and a good playlist, as music plays a crucial role in the experience. Wear loose-fitting clothing and try to avoid stressful situations prior to your treatment.

On Treatment Day

On treatment day, you will be welcomed into a comfortable, designated treatment room. Our rooms feature medical-grade recliners, adjustable colored/moving lights, books, and a video screen. You will self-administer the nasal spray under the close supervision of our healthcare professionals. As required by the FDA’s REMS program, we monitor you on-site for at least two hours to ensure your safety and address any potential side effects. We provide blankets, a pillow, and noise-cancelling headphones to help create a relaxing environment during your session.

After Treatment

After your session, we continue to monitor you until you are stable and ready to leave. This observation period is part of the REMS safety requirements designed to protect patients receiving Spravato® therapy. It’s important to have pre-arranged transportation, as you should not drive or operate heavy machinery for the rest of the day. Most patients can return to work or normal activities the following day. The treatment schedule typically starts with twice-weekly sessions for the first four weeks, then once-weekly sessions for the next month. Afterward, the frequency may be reduced to once every one to two weeks, based on your response and progress.

What Does Spravato Feel Like?

Patients undergoing Spravato treatment often report a range of sensations during and after the administration. Common experiences include a feeling of dissociation or detachment from reality, mild sedation, and a sense of relaxation. Some patients describe a floating sensation or a dreamlike state. These effects typically begin within minutes of using the nasal spray and can last for up to two hours. Other possible sensations include dizziness, nausea, and a temporary increase in blood pressure. It’s important to note that these experiences vary from person to person and are closely monitored by our medical staff during the treatment session to ensure safety and comfort.

Who Should Take Spravato

Spravato is intended for adults with treatment-resistant depression or major depressive disorder with acute suicidal ideation or behavior. Patient eligibility is determined through a comprehensive assessment by a healthcare provider, considering factors like medical history, response to prior depression treatments, and current mental health status. It’s crucial that patients have tried other antidepressants without adequate improvement before considering Spravato.

Therapeutic Infusions Amenities

  • Private Rooms: We offer private treatment rooms to ensure comfort and privacy.
  • Medical Recliners: Our rooms are equipped with comfortable medical recliners.
  • Dimming Lights: We provide dimming lights in each room to ease light sensitivity.
  • Total Comfort: We provide everything for your comfort during your treatment, including a pillow, blankets, eye masks, and noise cancelling headphones.
  • Monitoring by Trained Professionals: Our staff includes trained medical professionals who monitor patients throughout the infusion process.

Therapeutic Infusions | Ketamine Therapy in Delaware

Side Effects and Safety Measures

Spravato can cause side effects including dissociation, dizziness, nausea, sedation, increased blood pressure, and headache. Due to these risks, it’s administered in a healthcare setting with post-treatment observation. Patients should avoid driving or operating heavy machinery on treatment day. Our team conducts a review of medical history and current medications and provides individualized treatment planning.

Spravato vs. Ketamine

Spravato (esketamine) is a nasal spray form of ketamine, specifically the S-enantiomer of ketamine. While both are used in depression treatment, Spravato is FDA-approved for treatment-resistant depression and requires medical supervision. Ketamine, often used off-label for depression, is administered as an infusion or injection. Spravato’s nasal spray form allows for easier administration but still requires a healthcare setting due to potential side effects. Both can provide rapid relief from depressive symptoms but have different regulatory statuses and administration methods.

Safety First

Full Crash Cart On-Site

We prioritize the safety and comfort of our Spravato patients, offering a full “crash-cart” on-site. This ensures immediate response to any medical needs, enhancing the treatment experience with an added layer of security and care.

Medical Grade Recliners

Our patients can experience unparalleled comfort with our medical-grade recliners. These recliners are designed to provide optimal support and relaxation, ensuring a serene and comfortable environment during treatment sessions.

Medical Doctor On-Site

Our Spravato Treatments are administered with a fully trained and licensed medical doctor on-site. This guarantees immediate, expert medical attention in the rare event of an emergency, providing patients with an extra layer of security and peace of mind. All clinical staff is ACLS (Advanced Cardiac Life Support) certified.