Spravato

What is Spravato?

Spravato nasal spray is used in conjunction with oral medication to treat adults suffering from depression, which is resistant to other treatments. Spravato can also be used to treat depression symptoms in adults who have a major depressive disorder and suicidal thoughts and actions.

Spravato is only used in a medical setting. This medicine cannot be used at home. Spravato can only be used by adults in a specific program. You must register in the program, and you must understand the risks and advantages of this medicine.

Warnings

Spravato may cause extreme drowsiness or a feeling of being disconnected from the body, thoughts, or environment. Spravato should only be used in a medical setting where you will be closely monitored for at least two hours following each dose. After using spravato, you will need someone else to drive home. Spravato can cause suicidal thoughts in some people. Be mindful of any sudden shifts in mood or symptoms, including any that are new or worsening, and inform your doctor immediately.

Esketamine is associated with abuse and dependency. Before and during the treatment, your healthcare provider should monitor you for signs that indicate abuse or dependence. You should tell your doctor if you've ever abused alcohol, prescription drugs, or street drugs. Spravato can only be obtained through a program that is restricted. This program is called the spravato (risk evaluation and mitigation strategies) program. This medicine can only be administered in healthcare settings that are certified under the rems program and to patients who have enrolled in the rems program.

Spravato can worsen depression and cause suicidal behavior and thoughts, especially in the first few weeks of treatment. Inform your doctor immediately if there are any sudden or new changes in your mood, behavior, or thoughts.

Similar/related drugs

Sertraline, trazadone, lexapro, citalopram, zoloft, cymbalta, and wellbutrin

Before you take this drug

You should not take spravato if:

• A blood vessel disorder that affects your brain, chest, stomach, arms, legs, or heart
• Aneurysm history;
• A history of bleeding on your brain
• A condition that causes an abnormal connection between veins and arteries.

Tell your doctor if:

• Heart problems (such as chest pain, failure of the heart, or a disorder of the heart valves);
• You fainted because of slow heartbeats.
• High blood pressure
• A stroke or heart attack
• Brain damage, or an increase in pressure within your brain.
• Mental illness or psychosis
• Suicidal thoughts and actions
• A family history of depression
• Alcoholism, or drug abuse.
• Liver disease

Some individuals may experience suicidal tendencies after beginning antidepressant treatment. Regular visits to your doctor are a good way for you and your doctor to monitor the progress of treatment. Your family should remain aware of any significant shifts in mood or symptoms, which may indicate mental illness.

Do not use spravato if you are pregnant. Esketamine can harm an unborn child. You may find your name on a registry for pregnant women to monitor the effects of esketamine on the child.

How to take Spravato?

Spravato nasal spray is used by healthcare professionals. The nasal spray will be administered by you under the supervision of a healthcare professional. Spravato may cause nausea or vomiting. For at least two hours prior to receiving your dose, you should avoid eating anything. Avoid drinking liquids for 30 minutes prior to taking the medication.

Please read and follow all instructions for use that you receive. If you don't understand the instructions, ask your doctor or caregivers for help. You'll be closely monitored for at least two hours after using spravato. This medication can cause severe drowsiness or dissociation, which is a feeling of being detached from the body or emotions and distortions in your perceptions.

You will be told by your caregivers when you can leave the hospital after taking this medication. Someone will have to drive you back home. Do not drive anywhere until you have slept well the night before. Spravato can be taken up to two times a week initially, then every one to two weeks. You will be told by your doctor how often to take the medicine.

Dosing information

Adult dose for depression:

Induction section:
weeks 1–4:
-on day one, take 56 mg intranasally once.
Subsequent doses: 56 to 84 mg intranasally, 2 times per week
maintenance phase
weeks 5-8: 56-84 mg once weekly intranasally
weeks 9 and beyond: 56–84 mg intravenously every 2 weeks, or one dose per week.
Comments:
-important considerations: treatment sessions must be overseen directly. The sessions should include the nasal administration of doses and post-administration observations.
Patients who require nasal corticosteroids or decongestants should use the agent(s) at least 1 hour before using this drug.
Patients should be told to refrain from eating or drinking anything for 2 hours prior to the injection.
After the induction phase is complete, the evidence of therapeutic benefits should be evaluated. This will determine whether or not the treatment needs to continue.
After week 8, dosing should be reduced to the lowest frequency to maintain remission.
Use in combination with oral antidepressants for the treatment of treatment-resistant depression.

Adult dose for depressive disorder, other:

84 mg, 2x per week, intranasally
after 4 weeks, the evidence of therapeutic benefits should be evaluated in order to determine whether or not treatment needs to continue.
Comments:
if symptoms are intolerable, the dosage can be reduced to 56mg intranasally twice a week.
This drug is not intended to prevent hospitalization, even if the patient improves after the first dose.
-important considerations: treatment sessions must be overseen directly. The sessions should include the nasal administration of doses and post-administration observations.
Patients who require nasal corticosteroids or decongestants should use the agent(s) at least 1 hour before using this drug.
Patients should be told to refrain from eating or drinking anything for 2 hours prior to the injection.
Use: as a combination with oral antidepressants for the treatment of depressive symptoms in adults with mdd with acute suicidal behavior or ideation.

Adult dose for major depressive disorder:

84 mg, 2x per week, intranasally
after 4 weeks, the evidence of therapeutic benefits should be evaluated in order to determine whether or not treatment needs to continue.
Comments:
if symptoms are intolerable, the dosage can be reduced to 56mg intranasally twice a week.
This drug is not intended to prevent hospitalization, even if the patient improves after the first dose.
-important note: treatment sessions must be closely supervised. The sessions should include the nasal administration of doses and post-administration observations.
Patients who require nasal corticosteroids or decongestants should use the agent(s) at least 1 hour before using this drug.
Patients should be told to refrain from eating or drinking anything for 2 hours prior to the injection.
Use: as a combination with oral antidepressants for the treatment of depressive symptoms in adults with mdd with acute suicidal behavior or ideation.

What happens if i miss the dose?

If you forget to take your spravato, call your doctor and ask for directions.

What happens if i overdose?

Overdoses are unlikely because this medicine is administered by a health professional in a medical environment.

What should be avoided?

Use spravato nasal spray only after using other nasal medications for at least 1 hour. After your spravato dosage, do not drive or perform any other activity that requires alertness and awareness.

Side effects of Spravato

If you experience any of the following symptoms of an allergic reaction: hives, difficulty breathing, swelling of the face, lips, or tongue, or difficulty breathing, seek emergency medical attention.

You will need to check your blood pressure before and after using spravato. Esketamine may increase blood pressure several hours after a dose. Inform your doctor if chest pain, difficulty breathing, a severe migraine, or blurred vision occur.

Call your doctor immediately if you:

• Feeling like you could pass out or experiencing extreme drowsiness
• Dizziness, or the feeling of floating, can be severe.
• Unusual changes in mood or behavior
• Thoughts of harming yourself
• Worsening depression;
• Sleep problems
• Problems with memory or thinking;
• Flashbacks are memories that are unpleasant or unusual.
• Hallucinations or feeling "spaced out".
• Urination problems: painful urination; increased urination; urgent need to urinate.

Common spravato side-effects include:

• Dissociation, feeling drunk;
• Increased blood pressure
• Drowsiness;
• Dizziness, spinning sensation;
• Feeling anxious
• Nausea, vomiting,
• Sensations (touch or other senses) that are reduced

There may be other side effects. For medical advice on side effects, call your doctor. The fda can be contacted at 1-800-fda-1088 to report side effects.

Interaction with other drug

Tell your doctor about your other medications, including:

• Opioid medication
• A sleeping pill or muscle relaxer
• Medicines for anxiety such as diazepam, valium, or xanax;
• Including diet pills or adhd medications such as adderall or ritalin.
• Medicine to treat narcolepsy
• Mao inhibitors such as isocarboxazid (linezolid), methylene blue injection (phenelzine), rasagiline (selegiline), tranylcypromine, and others

This list is incomplete. Esketamine may interact with other drugs, such as prescription and over-the-counter medicines, vitamins, and herbal products. This list does not include all drug interactions.