Can a Nasal Spray Effectively Treat Depression? What You Need to Know About Spravato

At least 21 million adults in the U.S. have experienced depression, and while oral antidepressants are a common treatment, they don’t work for everyone. Now, the FDA has expanded approval for Spravato, a nasal spray from Johnson & Johnson, to be used as a standalone treatment for people with severe depression who haven’t found relief with other options.

Spravato was first approved by the FDA in 2019 for treatment-resistant depression, but it was required to be used alongside an oral antidepressant. The new approval means it can now be used alone, without needing to combine it with other medications.

However, Spravato is a controlled substance and isn’t available over the counter. You can’t just pick it up at your local pharmacy. Here’s what you need to know about Spravato and its potential side effects.

What Is Spravato?
Spravato, or esketamine, is a chemical form of the anesthetic ketamine. While ketamine is often associated with recreational use and is known as “Special K,” it has also been used off-label in some wellness clinics for treating depression. Unlike Spravato, this off-label use isn’t FDA approved.

Studies show that Spravato is highly effective for treatment-resistant depression. The nasal spray has shown a statistically significant effect on severe depression, with some users feeling better within just a few days of starting treatment.

Spravato must be administered under strict supervision. It is only available through a restricted distribution system due to its potential for misuse. After taking it, patients are monitored for at least two hours at a treatment center to check for any side effects.

How Does Spravato Work?
Spravato works by targeting a different system in the brain compared to typical antidepressants. It affects glutamate, a neurotransmitter believed to play a role in depression, and boosts mood by improving brain connectivity. Unlike traditional antidepressants, it doesn’t directly affect serotonin, norepinephrine, or dopamine.

What makes Spravato stand out is how quickly it works. While most antidepressants take weeks to show results, Spravato can begin working in hours or just a day.

Who Is Spravato Best For?
Spravato is for adults with major depressive disorder who haven’t responded to at least two oral antidepressants. Currently, it is only approved for adults, and it’s not known whether it’s safe or effective for children.

Potential Risks of Spravato
Like all medications, Spravato comes with potential side effects. These can include dissociation, dizziness, nausea, sedation, vertigo, anxiety, and increased blood pressure. It can also lead to a “drunk” feeling and other sensations of altered perception.

One of the main concerns with Spravato is the risk of high blood pressure, which is why patients are carefully monitored after treatment. It’s not recommended for pregnant or breastfeeding women.

Spravato also has a risk of addiction, abuse, and withdrawal, making it a substance that needs to be carefully managed. It is heavily regulated because of these risks. The importance of safety is clear, especially considering the dangers associated with unsupervised ketamine use.

If you’re considering Spravato, it’s essential to consult a healthcare provider. They can evaluate whether this treatment is right for you and guide you through the process. A psychiatrist experienced with ketamine and its related treatments will be able to help you decide if it’s a good fit for your depression treatment.