New Hope for Treatment-Resistant Depression
We are proud to offer REMS-certified Spravato treatment at Modern Mental Health for adults with treatment-resistant depression.
What is Spravato?
Spravato (esketamine) is a prescription nasal spray that offers a breakthrough approach in the treatment of depression, specifically for individuals with treatment-resistant depression or depression that causes suicidal ideations. Approved by the U.S. Food and Drug Administration (FDA) in 2019, Spravato is a novel medication that works differently from traditional antidepressants, providing a fast-acting alternative for patients who have not found relief from standard therapies.
How is Spravato different from other antidepressants?
Unlike traditional oral antidepressants, which can take weeks to start working, Spravato can begin to improve mood in just hours or days. Traditional oral antidepressants (SSRIs, SNRIs, tricyclics, MAOIs) typically work on serotonin, norepinephrine, and dopamine neurotransmitters in the brain. However, Spravato acts on an entirely different neurotransmitter called glutamate, the most abundant excitatory neurotransmitter in the human brain and central nervous system. Glutamate works to regulate emotions, memory, and other cognitive processes. It also stimulates the growth of new synapses (neural connections) between brain cells. Spravato is thought to work by facilitating the growth of new neural pathways, which allows for our minds to create thinking patterns and engage in new positive routines that alleviate depression. Spravato offers hope to those who have tried other treatments without success.
How often is Spravato administered?
The treatment protocol typically involves:
- Induction Phase: Twice-weekly sessions for the first four weeks.
- Optimization/Maintenance Phase: Once-weekly sessions during the second month, followed by treatments every one to two weeks thereafter, based on individual response and clinician assessment.
What happens during a Spravato visit?
Spravato treatment sessions must take place in a healthcare setting due to the need for clinical monitoring. The treatment involves the patient administering the nasal spray under the supervision of a healthcare provider. After the dose is administered, patients are closely monitored for side effects for a minimum of two hours, ensuring safety and comfort during the process. This supervision is crucial because Spravato can cause temporary changes in blood pressure, drowsiness, or dizziness. The good news, however, is that these side effects are likely to resolve completely by the end of the two-hour treatment session, giving our patients the confidence to return home safely. Patients are not allowed to drive home after the treatment, so arranging a ride is important. Public transportation, taxi, rideshare and walking are permitted.
What are the potential side effects of Spravato?
Commonly reported side effects of Spravato include:
- Dissociation: Feelings of detachment from oneself or surroundings.
- Dizziness: Sensations of lightheadedness or unsteadiness.
- Nausea: Upset stomach or the urge to vomit.
- Increased Blood Pressure: Elevations in blood pressure levels during and shortly after administration.
Due to these potential side effects, Spravato is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS). This ensures that the medication is administered in certified healthcare settings where patients can be appropriately monitored. Modern Mental Health is certified to administer Spravato in our clinic. A healthcare professional (psychiatrist or psychiatric nurse practitioner) is always on site and available during your treatment.
Where do I get Spravato?
To receive Spravato at Modern Mental Health, an initial evaluation with one of our providers is needed to ensure this treatment is clinically appropriate. If you are currently working with a psychiatric provider outside of our practice, you may continue to do so, and our staff will coordinate care with them prior to starting treatment.
How is Spravato administered at MMH?
Currently, Modern Mental Health offers Spravato Monday through Thursday at two different sessions, morning and afternoon. We have a dedicated space, separate from our main suite, we use exclusively for Spravato treatments. Our room has comfortable reclining chairs and divider screens for privacy, as there may be up to three patients receiving Spravato at the same time. The room is clean, comfortable and relaxing. Blankets and eye masks are provided for comfort, and the room is dimly lit. Many patients choose to read, listen to calming music (headphones required) or rest. We offer journals for your personal use to set intentions for your session if interested.
Video monitoring is used for your safety, but nothing is recorded. Our staff is monitoring and available at any time.
It is recommended to not eat 2 hours before and to not drink 30 minutes before your first treatment as some patients experience nausea.
Does my insurance cover Spravato?
Spravato is an FDA-approved treatment for depression, and therefore, most insurance plans can cover Spravato. Prior to starting, our administrative staff will check your individual benefits for Spravato and provide you with a cost estimate. We will work to obtain the prior authorization from your insurance plan, provided we are in-network. Currently, we accept Blue Cross Blue Shield PPO, Blue Choice PPO, Aetna, and Cigna plans. We will also assist you in signing up for all available payment assistance programs through the Spravato With Me savings program. This can minimize the out-of-pocket cost for you for both the medication and the administration. The prior authorization will require a mood questionnaire to be completed by the patient (we can send you this) and any pertinent past medical records, so obtaining these will be needed.
How can I get more information about Spravato?
If you have any questions regarding treatment with Spravato, please contact Modern Mental Health directly at practice@modernmentalhealthchicago.com or by calling 312-999-7809 and follow prompts for scheduling. Or, visit www.spravato.com for more information.
If you are ready to schedule your initial evaluation, please click Schedule Appointment below or at the top of this page. Any of our providers listed there can perform an evaluation for Spravato. Please choose a provider and select a New Patient Appointment: Office or Virtual (your choice) and comment that you are interested in Spravato after choosing a date. A member of our staff will contact you before your appointment.
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