Treatment-Resistant
Depression
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MDD with Suicidal
Thoughts or Actions
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Call Janssen CarePath at 877-CarePath (877-227-3728),
Monday–Friday, 8:00 AM to 8:00 PM ET.
Preparing for Treatment What to know if you’re considering SPRAVATO®
Working with Your Healthcare Provider
Your healthcare provider will remain an important part of your care throughout your month of treatment with SPRAVATO® for major depressive disorder with suicidal thoughts or actions.
If you’re considering SPRAVATO®, talk to your healthcare provider; get the facts and decide together if SPRAVATO® should be part of your overall treatment plan. Your healthcare provider can also help you find a certified SPRAVATO® treatment center to begin your treatment.
Expect to review your overall medical and depression treatment history in deciding with your healthcare provider whether SPRAVATO® is right for you.
- Be sure to tell your healthcare provider 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
- Ask if adding SPRAVATO® to your overall treatment plan might be a next step for you
- For more complete information, please see the Medication Guide
Planning Your Treatment with SPRAVATO®
SPRAVATO® cannot be purchased at a pharmacy. To help ensure the safe and appropriate use of SPRAVATO®, it is given at a certified SPRAVATO® treatment center. This could be a different location than your regular doctor’s office. Your healthcare provider will discuss the risks of misuse, abuse, sedation and dissociation with you and enroll you in the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program.
- If you are a new patient at your certified SPRAVATO® treatment center, you should not expect treatment on your first visit. A healthcare provider at the certified SPRAVATO® treatment center will do their own assessment to determine if SPRAVATO® may be right for you
- You will also be able to discuss the REMS Program, insurance matters, scheduling and treatment preparation
- You can ask what to bring with you on treatment days and how to prepare for your treatments
Starting SPRAVATO®?
Download the patient starter brochure to learn more about the SPRAVATO® treatment experience.
Treatment Days
Preparing for Treatment
You may start treatment as soon as your second visit to the SPRAVATO® treatment center.
Plan for rides to and from the treatment center. 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.
Bring a form of entertainment, like a book or playlist, for the session. A healthcare provider at the treatment center will monitor you for at least two hours after treatment.
Avoid eating two hours before, and drinking liquids 30 minutes before, the treatment session. Some patients taking SPRAVATO® may experience nausea or vomiting.
If you take a nasal corticosteroid or nasal decongestant medicine, take these medicines at least one hour before taking SPRAVATO®.
- At each session, you will be asked about your current depressive symptoms and how you are feeling over time
- After you administer SPRAVATO®, there will be an observation period of at least two hours, during which you will be allowed to rest comfortably while a healthcare provider monitors you for possible side effects
- SPRAVATO® can cause a temporary increase in your blood pressure that may last for about four hours after taking a dose. Your healthcare provider will check your blood pressure before you take SPRAVATO® and for at least two hours after you take SPRAVATO®. 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®
- Tell your healthcare provider if you have problems thinking or remembering
- Tell your healthcare provider if you have any side effect that bothers you or does not go away
- Before you leave, talk to your healthcare provider about your plans for the remainder of the day to figure out which activities may or may not be appropriate
- Be sure you have accurate contact information for the certified SPRAVATO® treatment center in case any questions or concerns come up after you leave
- Be sure to share your treatment experience with your referring healthcare provider, who will remain an important part of your care
How to Use SPRAVATO® Nasal Spray
You will administer SPRAVATO® yourself under the supervision of a healthcare provider, who will show you how to use the SPRAVATO® nasal spray device.
SPRAVATO® Side Effects
There’s an increased risk of suicidal thoughts and behavior with SPRAVATO®.
Call your healthcare provider right away if you have new or sudden changes in mood, behavior, thoughts or feelings, or if you develop suicidal thoughts or behavior.
SPRAVATO® may cause serious side effects, including sedation; dissociation; abuse and misuse; temporary increased blood pressure that may last about four hours after a dose; problems with thinking clearly; and bladder problems, such as a frequent or urgent need to urinate, pain when urinating or urinating frequently at night.
The most common side effects that can occur during and after taking SPRAVATO® include:
- Feeling disconnected from yourself, your thoughts, feelings and things around you (dissociation)
- Dizziness
- Nausea
- Feeling sleepy (sedation)
- Spinning sensation
- Decreased feeling of sensitivity (numbness)
- Feeling anxious
- Lack of energy
- Increased blood pressure
- Vomiting
- Feeling drunk
- Feeling very happy or excited
Your Month of Treatment
You’ll take SPRAVATO® twice a week for four weeks. After four weeks, you and your healthcare provider will determine if continued treatment with SPRAVATO® is necessary.
- At each session, you will be asked about your current depressive symptoms and how you are feeling over time
- After continuing treatment for four weeks, you may continue to take an oral antidepressant as instructed by your healthcare provider. You and your healthcare provider will determine if continued treatment with SPRAVATO® is necessary
- You should not stop taking SPRAVATO® without talking to your healthcare provider about your reasons and concerns, and working out an alternative treatment plan with them
Next:
Coverage & Cost Support
Information you may need to help you get started and stay on track.
Frequently Asked Questions
To help ensure the safe and appropriate use of SPRAVATO®, it is only available at certified SPRAVATO® treatment centers. Your healthcare provider can refer you to a certified SPRAVATO® treatment center. Even if your current healthcare provider doesn’t directly treat you with SPRAVATO®, they should remain a key partner in your treatment.
You can only get SPRAVATO® at certified SPRAVATO® treatment centers; ask your healthcare provider to help find a location. Because of the risks for sedation, dissociation, and abuse and misuse, SPRAVATO® can only be administered at healthcare settings certified in the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program.
On treatment days, you will administer SPRAVATO® nasal spray yourself under the supervision of a healthcare provider. Your healthcare provider will assess your blood pressure before and after you administer SPRAVATO® nasal spray.
After you administer SPRAVATO® nasal spray yourself, there will be an observation period of at least two hours during which you will be allowed to rest comfortably while a healthcare provider monitors you for possible side effects.
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 next day, following a restful sleep. So you’ll need to plan for rides on treatment days.
Tell your healthcare provider if you have any side effect that bothers you or does not go away.
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®.