October 24

At Home Esketamine vs. Spravato Treatment Center

 October 24

by Elijah Zoarski

Esketamine and Spravato are two pharmaceuticals that contain the active ingredient esketamine, which is a derivative of ketamine. They are both used to treat severe depression, especially when other antidepressant medications have not been effective. The main difference between the two is in the setting in which they are administered:

  1. At-Home Esketamine (Generic Esketamine):

    • Esketamine can be prescribed by a healthcare provider for use at home, and it is administered as a nasal spray.
    • Patients typically self-administer esketamine under the supervision of a healthcare professional in a healthcare setting initially to ensure safety.
    • Once it is established that the patient can tolerate the medication without adverse effects, they may be prescribed esketamine for at-home use.
    • Patients may be given specific instructions for how to use the medication, and they usually self-administer it on a regular basis, such as once or twice a week.
  2. Spravato Treatment Center (Brand Name Esketamine - Spravato):

    • Spravato is a brand name esketamine product developed by Janssen Pharmaceuticals and is administered in a clinical setting.
    • It is typically given as an intranasal spray and is administered under the supervision of a healthcare professional.
    • Patients need to go to a certified Spravato Treatment Center to receive their doses. The center is equipped to monitor the patient for several hours after administration due to potential side effects, including sedation and dissociation.

McLean Neuropsychiatric is a Certified In-Person Spravato Treatment Center

In order to be a certified Spravato Treatment Center, treatment must be administered in a clinic:

SPRAVATO® can only be administered at healthcare settings certified in the SPRAVATO® REMS Program. Patients treated in outpatient healthcare settings (e.g., medical offices and clinics) must be enrolled in the program. - Janssen Neuroscience (2023)

 In-person Spravato treatment in a clinical setting is often considered better for several reasons, primarily related to safety, monitoring, and the management of potential side effects:

  1. Safety and Supervision:
    • Spravato (esketamine) can have side effects, including sedation and dissociation. These effects can be unpredictable, and some patients may experience them more severely than others.
    • In a clinical setting, healthcare professionals are present to monitor patients closely during and after the administration of Spravato. This supervision allows for rapid response to any adverse effects and ensures patient safety.
  2. Dosing Accuracy:
    • In a clinical setting, healthcare professionals can ensure accurate dosing of Spravato. This is crucial because the medication needs to be administered at specific doses and intervals to be effective and safe.
  3. Emergency Response:
    • Clinics and Spravato Treatment Centers are equipped with medical equipment and staff trained to handle emergencies if they arise during treatment.
    • If a patient experiences severe side effects or has an adverse reaction, the clinical setting provides immediate access to necessary medical interventions.
  4. Regular Monitoring and Adjustments:
    • In-person treatment allows for regular assessment and monitoring of the patient's progress. The healthcare provider can make necessary adjustments to the treatment plan based on the patient's response to the medication.
  5. Reduced Risk of Diversion or Misuse:
    • Ketamine and esketamine are controlled substances with a potential for misuse. In a clinical setting, there is a reduced risk of the medication being diverted for non-medical use.
  6. Compliance and Accountability:
    • Patients receiving treatment in a clinical setting are more likely to adhere to the prescribed treatment regimen and follow-up appointments, enhancing treatment efficacy.
  7. Medical Evaluation:
    • Before starting Spravato treatment, patients typically undergo a comprehensive medical evaluation to determine their suitability for the treatment and identify any potential contraindications.

It's important to note that the choice between in-person Spravato treatment and at-home esketamine treatment should be made in consultation with a qualified healthcare professional at McLean Neuropsychiatric Treatment Center. We can assess your individual needs, medical history, and the severity of your depression to determine the most appropriate treatment setting for you. While in-person treatment provides important safety measures and monitoring, at-home treatment may be suitable for certain patients under specific conditions, such as when in-person treatment is not feasible due to mobility issues. Contact us today and we can guide you toward the best option for your situation!


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