SPRAVATO (Esketamine) Treatment For Depression

Treatment-resistant depression is defined as a depressive disorder that has not responded to two or more antidepressant medications.  While standard antidepressants (like SSRIs) act on serotonin or norepinephrine and take weeks to work, Spravato targets the glutamate system and can often show results within hours or days.

The SPRAVATO REMS (Risk Evaluation and Mitigation Strategy) is an FDA-mandated, restricted distribution safety program for Spravato (esketamine) nasal spray. It ensures the medication is only administered in certified clinics under direct supervision to mitigate risks of sedation, dissociation, and abuse, strictly prohibiting home use.

Spravato (esketamine) is administered intra-nasally (nasal spray) by the patient themselves. Other ketamine treatments are administered intravenously (IV) or as an intramuscular injection (IM). Alaska Serenity Clinic only offers Spravato (the only FDA-approved treatment).

Ketamine targets the NMDA receptor in the brain to increase glutamate activity, which helps form new neural connections for mood regulation.

• Induction Phase: twice weekly sessions for 4 weeks.
• Maintenance Phase: once weekly for 4 weeks, then as needed

• Patients self-administer the spray under healthcare provider supervision.
• Patients must remain in the clinic for at least two hours post-administration for safety monitoring.
• To reduce the risk of nausea or vomiting, do not eat for at least two hours before your session and avoid drinking liquids for at least 30 minutes prior.
• Patients cannot drive or operate machinery until the next day after a restful sleep.

Potential side effects include: 

• dizziness, 
• nausea, and 
• increased blood pressure. 

Vitals are checked before and during the session.

• Aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial and peripheral arterial vessels) or arteriovenous malformation. 
• History of intracerebral hemorrhage.

• Many major insurance plans cover Spravato for treatment-resistant depression with prior authorization. Our team will help verify your benefits and explore patient assistance programs  like SPRAVATO withMe to lower out-of-pocket costs.