Depression is a persistent mental health disease that affects one out of every six persons. Every year, an estimated 16 million American people suffer from depression. Antidepressant medicines, such as fluoxetine or citalopram, constitute the gold standard of care for depression.

However, in rare circumstances, antidepressant medication does not relieve depressive symptoms. People who continue to have depression symptoms after trying at least two different antidepressant drugs at the recommended dose for the recommended duration of time may be diagnosed with Treatment Resistant Depression (TRD). Many of these people will have taken many oral antidepressants with little to no improvement in their symptoms.

SPRAVATO™, a novel type of antidepressant medicine approved by the FDA for the treatment of TRD (esketamine).

What is SPRAVATO™ (Esketamine)?

Esketamine is a nasal spray medicine authorized by the FDA for the treatment of TRD and/or Major Depressive Disorder (MDD) with Suicidal Ideation (SI). When combined with oral antidepressant medication, esketamine has been shown to improve depressive symptoms in TRD patients. Because esketamine has the potential for dependence and/or addiction, it may not be recommended for patients who have a history of drug use disorder (s).

Outpatient psychiatrists must refer patients to our Esketamine Clinic. Treatments are only available by appointment; there is no walk-in service.

What are the treatment requirements?

• Must have a TRD or MDD with SI diagnosis.
• You must be taking at least one antidepressant drug orally.
• Must be participating in Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT) with a therapist (DBT)
• You must be under the supervision of an outpatient psychiatrist and have been referred to the Esketamine Clinic.

Additional information

• Only intranasal SPRAVATO™ is available at our Esketamine Clinic. TRD is not an FDA-approved indication for intravenous ketamine and is not available through the SPRAVATO™. Clinic under any circumstances.
• Esketamine can only be delivered in health care settings certified in the FDA-mandated SPRAVATO™. Risk Evaluation and Mitigation Strategy (REMS) Program, such as the Esketamine Clinic at MRH, due to the risks of drowsiness, dissociation, and abuse and misuse.
• Patients must be followed for at least 2 hours after medication administration, according to the REMS Program. Appointments usually last between 2.5 and 3 hours. Patients must be transported to and from treatment by a family member, friend, or other means of transportation, as they are not permitted to drive for the remainder of the day after receiving Esketamine.
• The cost of treatment is determined by insurance. Many commercial insurances are accepted at the esketamine clinic, although further insurance permission is frequently required for treatment clearance.
• SPRAVATO™ is not licensed for use in people suffering from bipolar disorder or schizophrenia. Esketamine may not be appropriate if you have a diagnosis other than TRD.

The Advantages of Spravato

• The FDA has authorized Janssen Pharmaceuticals' new drug, SPRAVATO™, for clinical depression in a historic decision. Esketamine, a chemical cousin of Ketamine, has been licensed for medicinal usage for the first time. The 14-2 vote, with one abstention, gives patients suffering from depression new hope.
• Prozac® was the last medicine licensed for depression almost 30 years ago. The issue with waiting so long for new medicine approval is that some forms of depression are resistant to particular medications.
• Spravato should only be used under the guidance of a doctor or after trying other depression drugs. This is because of its potency and potential dangers.

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