Spravato™ is a prescription nasal spray of esketamine, used for treatment-resistant depression (TRD) or Major Depressive Disorder (MDD) with suicidal thoughts.
Spravato ™ esketamine treatments cannot be used for pain relief or any other diagnosis and may not be prescribed to minors.
The FDA-approved drug esketamine is one version of the ketamine molecule, and makes up half of what is found in the commonly used anesthetic form of the drug, ketamine. It works similarly to ketamine but its chemical makeup allows it to bind more tightly to the NMDA glutamate receptors, making it two to five times more potent. This means that patients need a lower dose of esketamine than they do ketamine to experience positive results. The nasal spray (Spravato) allows the drug to be taken more easily in an outpatient treatment setting (under the supervision of a doctor), making it more accessible for patients than the IV treatments currently required to deliver ketamine. For more information, see this Yale Medicine article.
If you are provider interested in referring a patient, please see our Electronic Patient Referral or Referring Provider Form
Almost all insurance providers will cover Spravato™ if they deem the treatment the patient to meet the criteria for treatment. We pre-authorize every patient before treatment to ensure they will know the cost ahead of time. Patients with private health insurance can apply for a Janssen’s CarePath Account, which could result in co-pays as little as $10 for each Spravato treatment.
Spravato was developed because of the promising scientific results IV Ketamine infusions have shown in treating Major Depressive Disorder. It only contains S-Ketamine, while IV Ketamine infusions include a mixture of S-Ketamine and R-Ketamine. Spravato is also administered as a nasal spray while ketamine is administered via IV infusions at New Pathways Clinic. For a more detailed comparison see: Spravato Vs. Ketamine
There are two different types of Ketamine: R-Ketamine and S-Ketamine. While they are nearly identical molecules, they have slightly different effects on the brain. The type of Ketamine used in IV infusions is racemic, which means that is a mixture of R-Ketamine and S-Ketamine. Meanwhile, Esketamine (Spravato) is isolated to only contain S-Ketamine, which makes Spravato unique for Esketamine treatments.
Early scientific evidence suggests that both are effective treatments. IV Ketamine infusions of racemic Ketamine may present better outcomes due to a number of factors such as delivery method, dosage, and chemistry.
Please talk to your primary healthcare provider if you have concerns about any of the stated conditions.
Tell your primary healthcare provider about all medical conditions, particularly if you have:
Tell your primary healthcare provider about all the medicines that you take, including supplements. Spravato™ esketamine treatments may cause side effects when combined with other medicines.
Central Nervous System (CNS) depressants, psychostimulants, or Monoamine oxidase inhibitors (MAOIs) are of particular concern.
Please reference Janssen Pharmaceuticals’ Prescribing Information and Medication Guide or visit www.SPRAVATO.com.
If you are a patient, please talk with your primary mental health provider for more information.