Spravato® Therapy in Wilmington, Delaware

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.

Potential benefits of Spravato (esketamine) treatment include:

• 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.

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. It's a promising option for individuals seeking relief from the profound impact of chronic, unresponsive depression.

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.

All patients will undergo a thorough medical history review and screening to ensure safety and efficacy before starting treatment. Once approved, you will receive detailed instructions tailored to your needs. 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, 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. We monitor you 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 your session, we continue to monitor you until you are stable and ready to leave. 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. Regular follow-up appointments will help us monitor your progress and adjust your treatment plan as necessary.

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.

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.

Private Rooms: We offer private infusion 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.

Spravato can cause side effects like:

• Dissociation
• Dizziness
• Nausea
• Sedation
• Increased blood pressure
• Headache

Due to these risks, it's administered in a healthcare setting with post-treatment observation. 

• Post-treatment observation
• Avoid driving or operating heavy machinery on treatment day
• Review of medical history and current medications
• Individualized treatment planning

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 healthcare setting due to potential side effects. Both can provide rapid relief from depressive symptoms but have different regulatory statuses and administration methods.

Spravato treatment can provide life-changing relief, but long-term success comes from integrating these experiences into your daily life. The MAPS (Multidisciplinary Association for Psychedelic Studies) Workbook offers practical guidance to help you apply the insights from your Spravato sessions, promoting lasting growth and well-being. Explore the workbook below to support your ongoing healing journey.