SPRAVATO (Esketamine) Antidepressant Treatment

Depression is a chronic mental health condition affecting approximately 1 in every 6 adults. An estimated 16 million American adults struggle with depression every year. The standard of care for depression is treatment with antidepressant medications, such as fluoxetine or citalopram.

However, in some cases, depression symptoms do not improve with antidepressant treatment. Persons who continue to experience symptoms of depression after trying at least two separate antidepressant medications at an appropriate dose for the recommended period of time may be considered to have Treatment Resistant Depression (TRD). In many cases, these individuals will have tried multiple oral antidepressants with little to no relief in their symptoms.

In 2019, the FDA approved a new type of antidepressant medication for the treatment of TRD — SPRAVATO™ (esketamine). Memorial Healthcare System’s Esketamine Clinic at Memorial Regional Hospital (MRH) is the first certified esketamine treatment center in South Florida.

What is SPRAVATO™ (Esketamine)?

Esketamine is an FDA-approved nasal spray medication approved for treatment of TRD and/or Major Depressive Disorder (MDD) with Suicidal Ideation (SI). Esketamine has been proven to reduce depression symptoms in patients with TRD, when used in combination with oral antidepressant therapy. Esketamine has the potential for dependence and/or addiction and therefore may not be appropriate in patients with a history of substance use disorder(s).

Patients must be referred to our Esketamine Clinic by their outpatient psychiatrist. Treatments are appointment-based and there is no walk-in availability.

What are the requirements for treatment?

• Must have a diagnosis of TRD or MDD w/ SI
• Must be taking at least one oral antidepressant medication
• Must be engaged with a therapist, in either Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT)
• Must be in the care of an outpatient psychiatrist with a referral to the Esketamine Clinic

Additional information

• Our Esketamine Clinic only provides intranasal SPRAVATO™. TRD is not an FDA-approved indication for intravenous ketamine and is not provided under any circumstances through the SPRAVATO™ Clinic.
• Because of the risks for sedation, dissociation, and abuse and misuse, esketamine can only be administered at health care settings certified in the FDA-mandated SPRAVATO™ Risk Evaluation and Mitigation Strategy (REMS) Program, such as the Esketamine Clinic at MRH.
• The REMS Program requires patients be monitored for at least 2 hours following medication administration. Appointments typically take 2.5 to 3 hours.
• Patients must have transportation provided to and from treatment by a family member, friend, or other means of transportation, as patients are not allowed to drive for the rest of the day following Esketamine administration.
• Cost of treatment is dependent upon insurance. Many commercial insurances are accepted at the esketamine clinic, however, additional insurance authorization is often needed for approval of treatment.
• SPRAVATO™ is not approved for patients with bipolar disorder or schizophrenia. If you have a diagnosis other than TRD, esketamine may not be right for you.

Contact

For more information and to schedule an appointment, please e-mail LATClinic@mhs.net or call us at 954-265-4631.

8 am - 4:30 pm

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