Spravato (Esketamine) –

· FDA-approved treatment for major depressive disorder (specifically for depression that has not responded well to antidepressants) since 2019

· Administered via nasal spray

· Covered by all commercial insurances and Medicare.

· Requires in-office treatments:

o Twice weekly for four weeks, then

o Once weekly for four weeks, then

o Continued weekly treatments or every other week treatments for maintenance

· Individual treatment duration: 2 hours (nasal spray administered, then 2 hour monitoring period)

· Restrictions: Cannot drive for rest of day after treatment

Pros:

· One of the most effective treatments for depression that exists - 50% remission rate (depression resolved), 75% response rate (over 50% improvement)

· Independently effective and reducing suicidal thoughts, aside from its profound effect in treating depression

· Ketamine (although not spravato specifically) has been found to be very effective for treating not only depression, but also for anxiety disorders and PTSD.

· Vast majority of side effects wash out completely within two hours) and no significant side effects thereafter. No long-term side effects.

· Covered by insurance

Cons:

· Maintenance treatment is required to maintain the benefit of the medication

· Cannot drive for rest of the day after a treatment

Process:

· Schedule consultation with our neuromodulation expert, Dr. Ahmed

· If determined to be a good candidate, start treatment in about 2-3 weeks