How Does Spravato (esketamine) Work?

How Do Ketamine and Spravato (esketamine) Work?

What Is the Difference Between Ketamine and Spravato (esketamine)?

What Is Ketamine?

You may be familiar with ketamine as an anesthetic that was commonly used on

battlefields or as a veterinary drug. A much lower dose of ketamine is given for

depression compared with the dose necessary for anesthesia. This type of

Ketamine is racemic ketamine, a mixture of “R” and “S” ketamine. It was previously

approved by the Food and Drug Administration to be used as an anesthetic but

has not been approved as a treatment for depression. In addition, the American

Psychiatric Association found that there is not enough information about the use

of ketamine to treat MDD and TRD. There is not sufficient information because

ketamine is old, and pharmaceutical companies have chosen not to dedicate

millions of dollars to clinical trials for ketamine to be used as a depression

treatment.

Ketamine is usually administered intravenously because it metabolizes too fast

when given orally, and the effects are reduced. While the intravenous method is

often effective and provides rapid results, patients have to receive treatment as

much as three times a week and repeatedly have IV lines inserted, which is costly

and can be inconvenient to patients.

What Is Spravato (esketamine)?

Spravato is the brand name for Esketamine. It is a different version of ketamine

that can be administered intranasally and also produces rapid, effective results.

Esketamine is the S form of Ketamine. It is a new development, making

pharmaceutical companies more likely to endorse clinical trials supporting the

use of it. In 2019, the FDA approved the use of esketamine (Spravato) in adults for

the treatment of TRD and MDSI when used in conjunction with an oral

antidepressant.

The safety and efficacy of esketamine (Spravato) are supported by at least three

short-term and two long-term studies. A 2020 study by Papakostas studied the use

of esketamine in 774 people involved in 5 trials. It showed that patients with MDD

or MDSI who received the intranasal esketamine treatments had a better

outcome than those who received a placebo.

Conventional antidepressants may increase suicidal thoughts at the beginning of

treatment, especially in children and young adults. Esketamine (Spravato) is the

only drug besides lithium, a drug commonly prescribed for bipolar disorder, that

is proven to decrease suicidal thoughts.

There are currently no ongoing trials comparing the use of ketamine and

esketamine against each other.



How the Difference Between Ketamine and Spravato (esketamine) Administration Affects You

Esketamine (Spravato) is more potent than ketamine, which allows doctors to give

lower doses and potentially see fewer side effects. Both ketamine and esketamine

must be administered by an RN, PNP, or doctor. These drugs are DEA Schedule III

controlled substances and can become highly addictive.

Ketamine must be administered intravenously up to 3 times a week. This can be

inconvenient and painful as patients have to continue to return to the clinic and

receive a new IV injection each time.

Spravato (esketamine) is administered in an outpatient setting under our RN, PNP,

or doctor supervision. You receive three doses of the medication spaced about 5

minutes apart, and then you remain under supervision for 2 to 3 hours until any

potential side effects have passed.

The side effects for both Spravato (esketamine) and Ketamine can include

• Nausea
• Drowsiness
• Increased blood pressure
• Dissociation (sometimes called out-of-body experiences)
• Headache

The side effects tend to peak at 40 minutes and wear off within two hours of

treatment. You can expect the most intense side effects during the first two

treatment sessions.



Will Insurance Cover Ketamine or Spravato (esketamine) Treatments?

Insurance companies do not cover ketamine treatments because it’s experimental

and not FDA-approved. Therefore, you have to pay out of pocket for it.

Spravato (esketamine) is almost always covered by insurance, including Medicare,

because it is FDA-approved and well-studied to be effective and safe. To be

considered eligible for insurance coverage for Spravato (esketamine), a person

has to have tried at least two other antidepressants without benefit.



Explore Your Treatment Options With Unchained

Wellness Clinic

Ketamine and Spravato (esketamine) are both viable treatments for depression.

When effective, people usually respond within one to three sessions. If a person

has no response after three sessions, further sessions are unlikely to help.

Instead, it’s probably best to try other treatments for depression.

One additional treatment option is TMS (transcranial magnetic stimulation).

TMS is an FDA-approved, noninvasive, highly effective treatment option for people

with MDD. Numerous studies have been performed on the effectiveness and

safety of TMS, and the outcomes have been favorable. At Unchained Wellness

Clinic, we have highly trained professionals who work with the latest technology

and well-researched treatment options to help you feel better by individualizing

the best treatment strategies.



Talk with us today!

Experience transformative relief and reclaim your mental health with our

Ketamine and Spravato treatments at Unchained Wellness Clinic – book your

consult today and discover the path to renewed well-being!