Esketamine For Depression In Tampa & Wesley Chapel, Florida

Ketamine is a controlled substance, used for decades in Anesthesia and recently in Psychiatry, to provide rapid improvement for symptoms of depression, without the delayed onset or side-effects of traditional antidepressants.

Ketamine is a revolutionary new treatment for depression. It works quickly and has minimal side effects compared to other current treatments. It was traditionally done as an Intravenous infusion which required extensive monitoring and expense. A newer intr-nasal treatment route called Esketamine allows for lower doses, making the process safer and more accessible as insurance covers it.

Depression is a common, severe, and potentially life-threatening disorder. Several preclinical and clinical studies suggest that the glutamatergic system is involved in the mechanism of action of antidepressants. The non-competitive NMDA antagonist like ketamine or esketamine has been shown to have a rapid (hours) therapeutic effect in severe depression or treatment-resistant depression. Intravenous (IV), intramuscular, sublingual, or oral administration of subanesthetic doses of ketamine results in rapid, robust, and relatively sustained antidepressant effects, including the quick resolution of suicide ideation. The most recent formulation of ketamine is intranasal Esketamine or Spravato, which is currently the only formulation of ketamine derivative and route of administration approved for depression by the FDA.

Imagine that brain circuits are like busy highway intersections, with looping exits and entrances carrying information traffic at rush hour. With stress, the traffic increases, and the wear-and-tear repair crews that fill potholes can’t keep up. Traffic piles up and slows down. Such a process can produce mood to slow down and cause depression in the brain. Esketamine waves traffic around the bottlenecks jump-starts the natural repair processes, and within days, sometimes within hours, the brain impulse traffic breaks through and starts flowing again.

Yes. Most insurance plans cover S-Ketamine, Esektamine, or Spravato. 

The FDA has approved Esketamine to treat depression. Most insurance plans cover Esketamine for patients suffering from depression but don’t have adequate relief of depressive symptoms using classical antidepressants. Based on your individual insurance plan, we can find out your copay.

Spravato Nasal Treatment (esketamine) is FDA cleared for Major Depressive Disorder (depression that has not responded adequately to medication treatment) in adults only. Any other use would be considered off-label.

The Spravato labeling contains a Boxed Warning that cautions that patients are at risk for sedation and difficulty with attention, judgment and thinking (dissociation), abuse and misuse, and suicidal thoughts and behaviors after administration of the drug. Other side effects include but are not limited to Dissociation, Dizziness, Nausea, Sedation, Vertigo, Headache, Dysgeusia, Hypoesthesia, Anxiety, Lethargy, Blood pressure increased, Vomiting, Insomnia, and Diarrhea. I also understand the potential side effects form Spravato nasal treatment may include: Nasal discomfort, throat irritation, feeling drunk, dry mouth, hyperhidrosis (sweating), euphoric mood, dysarthria, tremor, oropharyngeal pain, mental impairment, constipation, pollakiuria, feeling abnormal, tachycardia (elevated heart rate), abuse, misuse, and physiological dependence.

There are alternatives to Spravato treatment, including TMS, intensive therapy (IOP/PHP), alternative medications, ECT, and ketamine infusions.

Spravato has been shown to reduce depressive symptoms in adults who have experienced unsatisfactory results with antidepressants and therapy. Spravato should be administered in conjunction with an oral antidepressant.

There is a risk for abuse and physical and psychological dependence with Spravato treatment. Your healthcare provider should check you for signs of abuse and dependence before and during treatment with Spravato. Tell your healthcare provider if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs. Your healthcare provider can tell you more about physical and psychological dependence and drug addiction differences.

Before the treatment visit, we will ask you to refrain from eating 2 hours prior to treatment and refrain from drinking 30 minutes prior to treatment. Esketamine is indicated for intranasal use only. The starting dose is 56mg, and subsequent doses are 56mg or 84mg. An experienced Esketamine technician will supervise the self-administration of Esketamine. You may relax comfortably while being monitored for two hours after self-administration.

The Esketamine technician will observe with you for the observation period. They will be asking you a series of questions about how you are feeling. We will record your vital signs, your mood and anxiety levels, and any side effects you experience for up to 2 hours after administration of esketamine.

Esketamine is not recommended during pregnancy. There are insufficient data on Esketamine use in pregnant women to draw conclusions about any drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. If a woman becomes pregnant while being treated with Esketamine, treatment with Esketamine should be discontinued, and the patient should be counseled about the potential risk to the fetus. Because of these unknown risks, women cannot take part in this treatment if they are:

· Pregnant

· Trying to become pregnant

· Breastfeeding

If you miss a period or think you or your partner might be pregnant during the treatment, you must tell the doctor immediately. If you become pregnant, you must stop taking part in the treatment. The doctor may ask for your permission to collect information about the outcome of your pregnancy and the condition of your newborn.

Spravato is contraindicated in patients with the following conditions:

• Aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels) or arteriovenous malformation

• History of intracerebral hemorrhage

• Hypersensitivity to esketamine, ketamine, or any of the excipients.

To achieve the desired results, a series of nasal treatments are needed. The protocol consists of twice-weekly appointments for 4 weeks, followed by weekly appointments for 4 weeks. Additional maintenance treatments may be considered on a case-by-case basis.