Spravato

Spravato helps in the fight against serious mental health conditions, such as depression and PTSD,  when traditional treatments do not work.

Everyone is different, and so is their journey with depression. This is why we ensure our Spravato treatment is right for you before it is prescribed.

At Elevate Psychiatry, our team of experienced professionals guide you through every step of treatment. 

Spravato nasal spray is a unique medication approved for use in adults diagnosed with the following conditions.

• Treatment-Resistant Depression (TRD): This condition is characterized by depression that remains unresponsive after you have undergone at least two different antidepressant treatments. A diagnosis of TRD is made when various classes of medications have been administered for some time without any significant improvement or if the treatment results in unbearable side effects.
• Major Depressive Disorder (MDD) with suicidal ideation (SI): MDD, also known as clinical depression, involves relentless feelings of sadness or a persistent, visibly irritable mood. It stands as one of the most prevalent mental health issues in the United States.

At Elevate Psychiatry, we have an established process for delivering Spravato treatment. This involves:

• Initial consultation and assessment: At Elevate Psychiatry, we start your journey with an easy-to-understand chat. You talk, we listen. We want to know how you feel and what makes you happy, sad, or stressed. We’re keen on knowing about the medicines you have tried before. We call this the “Initial Consultation.” It helps us understand you better.
• Creation of personalized treatment plan: Remember, everyone is different. What works for your friend might not work for you. Therefore, we make a special plan just for you. We will recommend Spravato treatment if it is appropriate for you.
• Regular check-ins and modifications as needed: We want to ensure your treatments are beneficial for you. So, we will have regular sessions with you to see how you’re doing. These “Regular Check-Ins” help identify if we need to change something in your plan to help you more. 

Remember, you’re not alone on this journey. We also offer other ways to help, like esketamine and other mental health treatments. 

Here are the steps we recommend to prepare for your Spravato treatment..

• Arrange transportation: Make sure to organize a ride home by asking someone you know or booking a ride-sharing service. You should not drive until the day after your treatment, following a restful night's sleep.
• Manage your diet: Avoid eating for four hours before your treatment and refrain from drinking any liquids for 30 minutes before your session. On treatment days, avoid light meals and greasy or heavy foods to reduce the risk of nausea or vomiting.
• Handle medications carefully: If you're using nasal decongestants or nasal corticosteroids, take them at least an hour before your Spravato session to avoid increased blood pressure and/or sedation during treatment.
• Substance restrictions: Abstain from alcohol for 24 hours before your treatment, as it can diminish the effectiveness of the session. If you're taking Lamictal or benzodiazepines, avoid these within 6 hours of your treatment.
• Ensure relaxation and rest: Spend the evening before your session relaxing and engaging in activities you enjoy. It's best to avoid stress-inducing media, movies, or music to ensure you're calm for your treatment.

The generic name for the active ingredient in Spravato is esketamine, a compound developed from ketamine. Esketamine is a more concentrated form of ketamine, which the U.S. Food and Drug Administration (FDA) has specifically approved for nasal spray administration to treat individuals with TRD and MDD.

Esketamine originates from a specific part of the ketamine molecule, offering a higher potency that allows for effective treatment at lower doses and potentially results in fewer side effects.

As Spravato nasal spray has received FDA approval, it is typically covered by most health insurance plans, making it accessible to patients requiring this form of treatment.

Spravato operates differently from traditional antidepressant medications.

Typical antidepressants work by boosting the levels of naturally occurring neurotransmitters like serotonin, norepinephrine, and dopamine in the brain. This enhancement causes better communication between neurons, which can improve your mood.

In contrast, Spravato takes a different approach. It doesn't increase serotonin, norepinephrine, or dopamine. Instead, Spravato targets a different receptor in the brain, the NMDA receptor, to heighten glutamate levels. Glutamate is the most abundant excitatory neurotransmitter in the brain and plays a critical role in neural function.

By raising glutamate levels, Spravato promotes the development of new neural pathways, enhancing the brain's communication network. This is especially relevant in depression, where it's understood that there's not enough communication across different brain regions, leading to symptoms such as persistent negative thoughts, cognitive impairments, and feelings of despair.

Spravato can bring about improvements quickly, with many patients experiencing benefits after only a few sessions.

The most frequently observed side effects of Spravato include dizziness and a short-term rise in blood pressure. Additionally, it may cause sensations of disassociation or sedation.

For this reason, Spravato is given in a medical environment under close supervision, ensuring you stay in our office until these side effects have subsided. Typically, side effects are more pronounced during the initial two sessions and tend to lessen with subsequent treatments.

Other potential side effects may involve:

• Nausea
• Sleepiness
• Headaches
• A feeling similar to intoxication
• Anxiety
• Elevated mood or excitement

Spravato may be an option for you if you're dealing with Treatment-resistant depression or major depressive disorder and haven't found success with other treatments. It's specifically suited for those who do not have a history of alcohol or substance abuse disorders or significant medical conditions.

However, Spravato is not recommended if you have certain health issues, including:

• Blood vessel disease
• A history of brain hemorrhage
• An abnormal connection between veins and arteries
• Allergies to esketamine, ketamine, or any of Spravato's ingredients

Before starting Spravato, you must inform us about all the medications and supplements you're currently taking, along with any existing health conditions. This information is crucial to assess whether Spravato is a safe and appropriate treatment option for your overall health.

Spravato is an innovative new treatment for those with depression. It offers unique treatment benefits, such as: 

1. Fast-acting relief: Spravato begins to alleviate symptoms quickly, offering relief from depression in a shorter time frame than traditional antidepressants.
2. Personalized care: Every person is unique, and the same plan is not suitable for everyone. Instead, we create a special Spravato treatment plan just for you. We take the time to understand your feelings, your life, and how depression affects you. This helps us decide the best way to use Spravato treatment for you. 
3. Comfort: We know it can be scary to try something new, especially when it comes to your health. We work hard to make you feel safe and comfortable during your Spravato treatment. We make sure our clinic feels like a safe place. It’s clean, calm, and quiet. The chairs are comfy, and the rooms are private. You can relax during your treatment.
4. Safety:  We have top-notch healthcare professionals who will watch over you. They monitor you during your treatment, from start to finish and check on you to make sure you’re feeling okay. If you have any questions or worries, our providers are available to help.
5. Reduces suicidal ideation: Unlike many standard antidepressants, which can sometimes heighten suicidal ideation, particularly in the early stages of treatment, Spravato stands out as one of the few medications demonstrated to lower such thoughts.
6. Tackles treatment-resistant depression: Addressing TRD presents a significant challenge. Since its approval by the U.S. Food and Drug Administration (FDA) in 2019, Spravato has been recognized as an effective option for managing TRD, with numerous studies supporting its efficacy.
7. Creates new neural pathways: Studies indicate that Spravato plays a crucial role in developing new neural connections. A modern perspective on depression suggests that the condition might stem from disrupted communication pathways in the brain. Constant negative thinking can lead to the neglect of alternative neural pathways, increasing depressive symptoms. Spravato has been shown to be particularly effective in promoting the formation of new neural connections, aiding in the brain's recovery from the impacts of prolonged depression.

In addition to Spravato treatments, we offer various other mental health treatment plans. We can help with many different problems, all under one roof.

Depression is challenging but remember – you don’t have to face it alone. With Spravato treatment, a hopeful tomorrow awaits you. 

Our team at Elevate Psychiatry is committed to helping you find relief from treatment-resistant depression and guide you on your journey to better mental health.

Book an appointment online or get in touch with us at one of our three locations:

• Coconut Grove:   (305) 908-1115
• Doral:    (305) 908-1115
• Brickell:    (305) 908-1115