Spravato (Esketamine)
Mechanism of Action:
Spravato works by blocking the N-methyl-D-aspartate (NMDA) receptor in the brain. This action increases the release of glutamate, a neurotransmitter that plays a role in mood regulation.
Indications:
- TRD in adults who have not responded to at least two previous antidepressant treatments
- Depressive symptoms in adults with major depressive disorder (MDD) who have acute suicidal ideation or behavior, in conjunction with an oral antidepressant
Administration:
Spravato is administered as a nasal spray in a healthcare provider’s office. Patients typically receive two treatments per week for the first four weeks, followed by less frequent treatments as needed.
Side Effects:
The most common side effects of Spravato include:
dissociation, sedation, nausea, increased blood pressure, and dizziness.
Precautions:
Spravato is a controlled substance and has the potential for abuse and misuse. It should not be used by pregnant or breastfeeding women, or by people with a history of substance abuse. Patients should be carefully monitored for signs of dissociation or other adverse reactions during and after treatment.
Cost and Availability:
Spravato is a prescription medication and may be expensive. It is available only through certified healthcare providers who participate in the Spravato Risk Evaluation and Mitigation Strategy (REMS) program.
Conclusion:
Spravato is a novel treatment option for TRD that works by modulating glutamate levels in the brain. It can provide rapid relief of depressive symptoms, but it is important to be aware of the potential risks and precautions associated with its use.
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