SPRAVATO® FAQs
Still have questions? Below, find answers to frequently asked questions you may have about getting treated with SPRAVATO®.
SPRAVATO® FAQs
Before you take SPRAVATO®, talk to your healthcare provider about your full medical and depression treatment history, including if you have a history of abusing prescription or street drugs, or a problem with alcohol.
Do not take SPRAVATO® if you have a blood vessel disease (aneurysm), an abnormal connection between your blood vessels (arteriovenous malformation), a history of bleeding in the brain or if you are allergic to esketamine, ketamine or any of the ingredients in SPRAVATO®.
Be sure to tell your healthcare provider if you have heart, brain or liver problems; if you have psychosis; or if you are pregnant, planning to become pregnant, breastfeeding or planning to breastfeed. You should not take SPRAVATO® if you are pregnant. You should not breastfeed if you are taking SPRAVATO®.
Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.
These are not all the conditions you should tell your healthcare provider about before starting SPRAVATO®. For a full list of conditions, please see the Medication Guide.
SPRAVATO® (esketamine) CIII nasal spray is a derivative of ketamine. SPRAVATO® is an FDA-approved nasal spray for treatment-resistant depression; it is also approved to treat depressive symptoms in adults with major depressive disorder with suicidal thoughts or actions. Ketamine has not been approved by the FDA to treat depression. Both SPRAVATO® and ketamine are Schedule III controlled substances under the US Controlled Substances Act.
You cannot take SPRAVATO® on your own. You will administer SPRAVATO® nasal spray yourself under the supervision of a healthcare provider, at a certified SPRAVATO® treatment center. You can choose the location that works best for you; ask your healthcare provider to help find a location. SPRAVATO® cannot be purchased at a pharmacy. Because of the risks for sedation or loss of consciousness, dissociation, respiratory depression, and abuse and misuse, SPRAVATO® can only be administered at healthcare settings certified in the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program.
No, treatment with SPRAVATO® is not recommended during pregnancy or while breastfeeding. SPRAVATO® may harm your baby. You should let your healthcare provider know if you are pregnant, planning to become pregnant, breastfeeding or planning to breastfeed. If you are a woman planning to start SPRAVATO®, and are of childbearing age, you should use highly effective contraception while taking SPRAVATO®. Talk with your healthcare provider about methods of birth control that should be used.
If you become pregnant while being treated with SPRAVATO®, you should talk to your healthcare provider as soon as possible about discontinuing treatment and about other options for treating your depression.
There is a pregnancy registry for women who are exposed to SPRAVATO® during pregnancy. The purpose of the registry is to collect information about the health of women exposed to SPRAVATO® and their baby. If you become pregnant during treatment with SPRAVATO®, talk to your healthcare provider about registering with the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or online.
Do NOT take SPRAVATO® if any of the following applies to you:
You are allergic to esketamine, a similar medicine called ketamine used for anesthesia, or any of the other ingredients in SPRAVATO®.
You have a blood vessel disease (aneurysm), an abnormal connection between your blood vessels (arteriovenous malformation) or a history of bleeding in the brain.
Be sure to tell your healthcare provider if you have heart, brain or liver problems; if you have psychosis; or if you are pregnant, planning to become pregnant, breastfeeding or planning to breastfeed. You should not take SPRAVATO® if you are pregnant. You should not breastfeed if you are taking SPRAVATO®.
Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements.
You can discuss with your healthcare provider at the certified SPRAVATO® treatment center the specific personal items you might like to bring with you. These items might include headphones, a music player, a tablet, crossword puzzles or a book to pass the time, and a blanket and pillow to help you relax.
At each visit, your healthcare provider(s) will ask about your symptoms of depression, side effects and whether or not you are experiencing noticeable improvement. In the clinical studies of SPRAVATO®, a standardized scale called the Montgomery-Åsberg Depression Rating Scale was used to track treatment-resistant depression symptoms and response to treatment.
It’s a good idea to ask your healthcare provider(s) at the start of SPRAVATO® treatment how they will be evaluating your response to treatment, and what you can do to help with that. If your referring healthcare provider is not the same provider treating you with SPRAVATO®, you should ask when, and in what way, your new healthcare provider will be letting your referring provider know how your treatments are going and how you are doing.
It is very important to make every effort to stay on the treatment plan that you and your healthcare provider have made. However, if you do miss a treatment, contact your healthcare provider as soon as possible to discuss how they would like to address this situation. Your healthcare provider may decide to change your dose, or dosing frequency, because of missed treatments.
You should ask your healthcare provider(s) what else you might do, beyond taking SPRAVATO® and your oral antidepressant, to help your treatment. If your healthcare provider has included some form of talk therapy in your treatment plan, you should continue that. Some people find that lifestyle changes, including exercise, dietary changes and better sleep can also help decrease depressive symptoms.
You should let all the healthcare providers involved in your care know how your treatments are going and how you are doing – especially if the healthcare provider helping with the overall management of your treatment is not the same provider who is treating you with SPRAVATO®.
Not all patients will respond to SPRAVATO®. Your healthcare provider will evaluate your symptoms of major depressive disorder over the four-week course of treatment to see if you have had satisfactory improvement.
After four weeks, talk to all of the healthcare providers involved in the management of your treatment about appropriate next steps. Do not stop your SPRAVATO® treatments without first discussing your reasons and concerns with your healthcare provider and formulating a treatment plan with them.
If you are using another nasal spray medicine or prescription, such as a nasal steroid or decongestant spray, you should not administer these within the hour before you will be taking SPRAVATO®.
If you have high blood pressure, whether treated or not, you should discuss that specifically with your healthcare provider in deciding whether SPRAVATO® may be right for you. Do not take SPRAVATO® if you have a blood vessel disease (aneurysm), an abnormal connection between your blood vessels (arteriovenous malformation) or a history of bleeding in the brain.
SPRAVATO® can increase your blood pressure temporarily – for about four hours – so you will have your blood pressure measured at various times, including before and after taking SPRAVATO®.
If your blood pressure is high before using this medicine, your healthcare provider will decide whether to start the medicine or wait until your blood pressure is lower.
Tell your healthcare provider right away if you get chest pain, shortness of breath, sudden severe headache, change in vision or seizures after taking SPRAVATO®.
Before starting SPRAVATO®, tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking SPRAVATO® with certain medicines or alcohol may cause side effects. Especially tell your healthcare provider if you take central nervous system (CNS) depressants, psychostimulants or monoamine oxidase inhibitor (MAOI) medicines. If you use a nasally administered medication like a nasal steroid or decongestant spray, do not administer it within the hour before you will be taking SPRAVATO®.
Some patients taking SPRAVATO® may experience nausea or vomiting. Because of this, you should avoid eating two hours before, and drinking liquids 30 minutes before, taking SPRAVATO®.
You should discuss your plans for the remainder of the day with your healthcare provider. Because of possible side effects affecting mental alertness and motor coordination, you won’t be able to drive, operate machinery or do anything where you need to be completely alert until the day after a treatment session, following a restful sleep, even if you think you feel well enough to do so. Because of this driving restriction, you will need to plan for your rides on treatment days.
SPRAVATO® may cause sleepiness (sedation or loss of consciousness), fainting, dizziness, spinning sensation, anxiety or feeling disconnected from yourself, your thoughts, feelings and things around you (dissociation). For these reasons, do not drive, operate machinery or do anything where you need to be completely alert until the day after a treatment session, following a restful sleep, even if you think you feel well enough to do so.
SPRAVATO® Patient Brochure
The SPRAVATO® Patient Brochure is a helpful resource to learn about SPRAVATO® and treatment-resistant depression.
SPRAVATO® Patient Discussion Guide
Download the Patient Discussion Guide to learn more about the SPRAVATO® treatment experience and insurance, and help you discuss SPRAVATO® with your doctor.