Spravato, a newly FDA-approved nasal spray, offers hope for individuals with treatment-resistant depression, a condition affecting around 8.3% of adults. This treatment provides rapid relief from depressive symptoms and is designed for patients who do not respond to or cannot tolerate traditional oral antidepressants. These medications, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), have been in use since the 1950s but are not effective for everyone.
Spravato: A Promising New Treatment for Treatment-Resistant Depression
Bill Martin of Johnson & Johnson highlighted the complexity of treatment-resistant depression, noting that it leaves patients with limited options, particularly those who have not responded to oral medications. Although these antidepressants are frequently prescribed, they aren’t effective for everyone and can be challenging to discontinue, as they often lead to withdrawal symptoms or relapse.
Spravato is derived from esketamine, a compound related to ketamine, which is an FDA-approved anesthetic that has shown promise in treating depression in clinical settings. Initially approved in 2019 as an adjunct treatment for patients with MDD who didn’t respond to two oral medications, Spravato has now received FDA approval as a stand-alone therapy, following a large study that demonstrated its superiority over a placebo.
How Spravato Works: Rapid Relief and Risks in Treating Severe Depression
The exact mechanism by which esketamine alleviates depression remains unclear, but it is known to target glutamate, the brain’s most abundant neurotransmitter. Patients may begin to notice improvements in their depressive symptoms within 28 days, with some experiencing relief in as little as 24 hours, all without the need for daily antidepressants.
Despite its potential side effects—such as sedation, dizziness, dissociation, and breathing problems—Spravato offers a promising treatment option for individuals with severe, treatment-resistant depression. However, due to these risks, it must be administered under supervision in a healthcare setting.
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