Spravato treatment, or Esketamine is a nasal spray used along with an oral antidepressant (by mouth) to treat adults with depression resistant to other treatments.
Esketamine is also used with an antidepressant taken by mouth to treat symptoms of depression in adults with major depressive disorder who have suicidal thoughts or actions. It is not known if esketamine can prevent suicide or reduce suicidal thoughts.
Esketamine is only used in a healthcare setting. You will not be able to use this medicine at home. Esketamine should be used only under a special program. You must be registered in the program and understand the risks and benefits of this medication.
How will I take SPRAVATO®?
- You will take SPRAVATO® Nasal Spray yourself, under the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the SPRAVATO® nasal spray device.
- Your healthcare provider will tell you how much SPRAVATO® you will take and when you will take it.
- Follow your SPRAVATO® treatment program exactly as directed by your healthcare provider.
- During and after each use of the esketamine nasal spray device, a healthcare provider will examine you and decide when you are ready to leave the healthcare environment.
- You should plan to have a caregiver or family member drive you home after taking SPRAVATO®.
- If you miss a treatment with SPRAVATO®, your healthcare provider may change your dose and treatment schedule.
- Some people taking SPRAVATO® experience nausea and vomiting. You should not eat for at least 2 hours before taking SPRAVATO® and not drink liquids for at least 30 minutes before taking SPRAVATO®.
- If you take a nasal corticosteroid or nasal decongestant, take them at least 1 hour before taking SPRAVATO®.
What is the most important information I should know about Spravato (nasal)?
You should not be treated with medicines if you are allergic to esketamine or ketamine, or if you have:
- a blood vessel disorder that affects the brain, chest, stomach, heart, or arms and legs;
- a history of aneurysm;
- a history of bleeding in your brain; either
- an abnormal connection between veins and arteries (a condition called arteriovenous malformation).
Tell your doctor if you have ever had:
- heart problems (such as chest pain, heart failure, or heart valve disorder);
- slow heartbeat that has caused you to faint;
- hypertension;
- a heart attack or stroke;
- a brain injury or increased pressure in the brain;
- mental illness or psychosis;
- family history of depression;
- alcoholism or drug addiction; either
- liver disease.
Some people have suicidal thoughts when they first take an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Do not use it if you are pregnant. Esketamine treatment may harm the fetus. Use effective birth control to prevent pregnancy, and tell your doctor if you become pregnant.
If you are pregnant, your name may appear in a pregnancy registry to track the effects of esketamine on the baby.
Do not take SPRAVATO® if:
- you have blood vessel disease (aneurysmal vascular) (including in the brain, chest, abdominal aorta, arms, and legs)
- has an abnormal connection between veins and arteries (arteriovenous malformation)
- have a history of bleeding in the brain
- are allergic to esketamine, ketamine, or any of the other ingredients in SPRAVATO®.
- If you are not sure if you have any of the above conditions, talk to your healthcare provider before taking SPRAVATO®.
Before taking SPRAVATO®, tell your healthcare provider about all of your medical conditions, including if:
have heart or brain problems, including:
- high blood pressure (hypertension)
- slow or fast heartbeat causing difficulty breathing, chest pain, lightheadedness, or fainting
- heart attack story
- history of stroke
- heart valve disease or heart failure
- history of brain injury or any condition where there is increased pressure in the brain
- have liver problems
- Have you ever had a condition called “psychosis” (seeing, feeling, or hearing things that are not there, or believing things that are not true)?
- are pregnant or plan to become pregnant. SPRAVATO® can harm your baby. You should not take SPRAVATO® if you are pregnant.
Tell your healthcare provider right away if you become pregnant during treatment with SPRAVATO®.
If you can become pregnant, talk to your healthcare provider about methods to prevent pregnancy during treatment with SPRAVATO®. A pregnancy registry exists for women who are exposed to SPRAVATO® during pregnancy. The purpose of the registry is to collect information about the health of women exposed to SPRAVATO® and their babies. If you become pregnant during treatment with SPRAVATO®, talk to your healthcare provider about registering with the National Antidepressant Pregnancy Registry at 302-595-4924 or online at SOZO Centers if you are breastfeeding or plan to breastfeed. You should not breastfeed during treatment with SPRAVATO®.
More information
Remember to keep this and all other medications out of the reach of children, never share your medications with others, and use Spravato only for prescribed indications. Always consult your healthcare provider to ensure that the information shown on this page applies to your personal circumstances.
