Ketamine Therapy
Spravato (esketamine) Clinic at the TTUHSC El Paso Department of Psychiatry - Transmountain
- We have recently introduced Spravato as the latest addition to our specialized outpatient services at the TTUHSC El Paso Department of Psychiatry - Transmountain. This is a valuable new tool with promising results in treatment-resistant depression (TRD) that was recently approved by the FDA.
- Ketamine is an anesthetic medication that is also used for analgesia and sedation.
Biochemically, ketamine is made of two mirroring parts, S-ketamine (esketamine) and R-ketamine. Ketamine and esketamine were shown to have a quick relieving effect in treatment-resistant major depression. It seems to have an especially effective impact in alleviating cases with
suicidal ideation. It has a different mechanism of action from other antidepressants.
Ketamine was first approved by the FDA as an anesthetic agent in 1970. In the 1990s, researchers demonstrated that ketamine infusion is quite effective and quick in treating depression, especially treatment-resistant depression. Studies have shown that ketamine infusion is quite effective for treatment-resistant depression. Spravato is a special formulation of esketamine that is applied as an intranasal spray rather than intravenous. It was approved by the FDA in March 2019 for the following indications: - Treatment-resistant depression (TRD) in adults.
- Depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior.
- It can only be administered under direct medical supervision in a physician's office or a clinic (to monitor for possible serious side effects and because of the potential for abuse and misuse). www.spravatohcp.com/trd/efficacy
- If you have treatment-resistant depression, you may be a candidate for Spravato treatment. Consult with your doctor or mental health professional and get a referral to our clinic at 915-215-8566.
- Based on reviewing currently available evidence, the scientists at the FDA decided that Spravato efficacy in treating TRD outweighs risks for its rare side effects. Therefore, it was determined as safe to administer with the conditions mentioned earlier.
- The overall incidence of side effects is relatively low (2%) and they usually go away in a few hours. However, they can be serious. The most common side effects include disassociation, dizziness, nausea, sedation, vertigo, fatigue, increased blood pressure, vomiting and anxiety. This is why the patient must remain under observation in the doctor’s office for at least two hours after getting the dose, and must not drive for 24 hours. www.spravatohcp.com/safety - TRD_Most_Common_Adverse_Reactions
- The medication itself is covered with a copay depending on your insurance company. There is an additional facility fee that may or may not be fully covered by your insurance.
- During the first induction four weeks, Spravato is administered twice a week. After that, a maintenance dose of once a week is followed for weeks five to eight. If indicated, treatment is given once every two weeks starting at week nine.
- Once check-in and the taking of vitals are completed, you will walked to the treatment room and self-administer Spravato intranasal spray in the presence of a health care professional. You will be monitored for two hours after receiving treatment. During this time, we recommend that you sit back and relax (by listening to music, TV, or reading – it’s all provided in the treatment room).
- No. Most patients will feel clear-headed within a half hour after the treatment. However, all patients must refrain from driving or operating heavy equipment until the following day. You will need a ride home following each treatment.
- This has not been specifically shown in studies yet. However, ketamine can and has been abused (as a psychedelic, party drug), and causes physiological and psychological dependence. Therefore, there may also be a risk for misuse and abuse of esketamine (Spravato), which may potentially cause physiological and psychological dependence as well. It is a Schedule III controlled substance. This is one of the reasons Spravato is only available through a special program and can only be given under direct medical supervision in a physician’s office or clinic.
For referral and additional information please call the TTUHSC El Paso Department of Psychiatry – Transmountain at 915-215-8566.