The FDA approved Spravato® as the first nasal spray treatment cleared for difficult-to-treat depression, as it’s shown strong results for people who haven’t responded to other medications. Like any treatment, it does carry some risk of side effects. But if you’ve been dealing with depression and not finding relief from other treatments, these risks are generally quite minor compared to what it feels like to live with ongoing depression symptoms.
What Is Spravato®?
Spravato®, the brand name for the chemical esketamine, is FDA-approved for treating depression that hasn’t responded to standard care, as well as major depressive disorder accompanied by suicidal thoughts. It’s classified as an NMDA receptor antagonist, meaning it acts on glutamate receptors in the brain. Glutamate’s job is essentially to “activate” other neurotransmitter systems, ramping up overall brain activity.
Dosage is delivered through a nasal spray, typically twice weekly for the first month, then tapering to a maintenance schedule every one to two weeks. Spravato® is typically combined with individual therapy and other antidepressant medications for the best, most comprehensive results. Your specific treatment timeline will depend on your symptoms and needs.
Working With Your Care Team to Alleviate Spravato® Side Effects
Managing Spravato®’s side effects starts with staying open and honest with your treatment team. Share any concerns or symptom changes with them, both during dosing and in the days after. They’ll track your progress, adjust your dose as needed, and support you through the process.
New Directions Mental Health providers hold REMS Certification, a credential confirming they have the training needed to safely manage medications with more complex risk profiles. This certification reflects our providers’ commitment to consistently high standards of safety and care.
Common Side Effects of Spravato®
Like most medications, Spravato® carries some potential for side effects. It’s considered low-risk overall, but responses vary from person to person.
Frequently reported side effects from Spravato® include:
- Drowsiness or sedation
- Fainting
- Dizziness or a spinning sensation
- Anxiety
- Dissociation, or feeling disconnected from your body, emotions, or surroundings
These effects are generally mild and short-lived, resolving within a few hours after dosing or after a good night’s sleep. A clinician monitors you for two hours following your dose to keep you comfortable and to respond quickly if anything more significant occurs.
Serious Spravato® Side Effects
Serious side effects are uncommon, but can include:
- Elevated blood pressure
- Trouble breathing
- Difficulty thinking clearly
- Bladder issues
Let your provider know right away if you experience chest pain, shortness of breath, a sudden severe headache, vision changes, or a feeling like you might faint after your dose.
Our team monitors every client for two hours post-dose to catch and respond to these effects.
Spravato® Comes With a Warning for Suicidality
Like many antidepressants, Spravato® carries a warning about increased risk of suicidal thoughts and behaviors, particularly in the early months of treatment. Tell your care team right away if you notice sudden shifts in mood, behavior, or emotional state, or if suicidal thoughts emerge.
If you are feeling suicidal or experiencing a mental health crisis, please reach out for immediate support by contacting your local emergency services, visiting your local emergency room, or calling/texting the National Crisis Hotline at 988.
Who Shouldn’t Take Spravato®
Spravato® isn’t the right fit for everyone with treatment-resistant depression. People with certain blood vessel conditions, arteriovenous malformations, a history of brain bleeds, or known allergies to the medication may not be good candidates. Anyone who’s pregnant or trying to conceive should discuss safety considerations with their provider first. Our psychiatric providers are well versed in determining whether Spravato® is a good, safe fit, so if you’re curious about this option, it’s worth speaking to someone further.
For those who aren’t eligible for Spravato®, transcranial magnetic stimulation (TMS) may be a better alternative. Our providers review your complete health history and personal concerns to help identify the treatment best suited to you.
Call New Directions Mental Health Today to Get Started
If treatment-resistant depression is affecting you or someone you love, and you want to learn more about Spravato® as an option, reach out to New Directions Mental Health at 724.374.7414 or schedule an appointment online.
We’re ready to answer your questions and walk you through our approach to treatment. Together, we can find a path toward managing your symptoms and improving your overall quality of life.
FAQs About Spravato®
Does Spravato® have long-term side effects?
Spravato® is generally very safe for extended use, and most side effects resolve within a few hours of dosing. However, people with high blood pressure may face a small risk of longer-term complications with continued use, which is why Spravato® isn’t typically recommended for those with existing vascular concerns.
How does Spravato® make you feel?
Many people describe the experience as dreamlike, since mild dissociation is common right after administration. Some say it feels like observing the experience from a distance rather than being fully present in it.
Does Spravato® impact your memory?
Clinical trials showed a temporary dip in cognitive function and memory for many clients, typically resolving within about 40 minutes. Brief memory effects right after administration usually aren’t cause for concern, but let your provider know if any cognitive or memory issues linger.
Can Spravato® cause high blood pressure?
Yes, a temporary blood pressure spike is possible, usually peaking around the 40-minute mark and lasting up to four hours. This is one reason clients are monitored for two hours after each dose.
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