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spravato® and im ketamine for depression

spravato® is FDA APPROVED FOR TREATMENT RESISTANT DEPRESSION

• At our practice since 2019, we have observed the life changing, transformational impact of SPRAVATO® on our patients’ lives, consistent with medical research studies. We are one of the most experienced SPRAVATO® treatment centers in the country having completed thousands of treatments since SPRAVATO® was FDA approved in 2019.

• SPRAVATO® (esketamine) CIII Nasal Spray is indicated, in conjunction with an oral antidepressant (AD), for the treatment of treatment-resistant depression in adults.

• It is currently covered by BCBS, Medicare, Aetna, United, Humana, Tricare, and Cigna often with as low as a $10 pharmacy co-pay for each treatment (with commercial insurance) as well as your regular specialist physician co-pay/deductible for each treatment.

• For patients that do not have pharmacy coverage for Spravato® treatment, we offer in office, monitored compounded intranasal ketamine from Sweetgrass Pharmacy or intramuscular (IM) ketamine. We bill your insurance for the physician/APRN/PA in office monitoring and you pay Sweetgrass Pharmacy directly for the medication (currently $75 from the pharmacy - call to confirm price). The out of pocket IM ketamine treatment cost is $100 for the medication each session, which is not covered by insurance plans (this is in addition to billing your insurance for the in office treatment monitoring).

• Our recommended treatment protocol for major depression is 2x per week for 4 weeks followed by 1x per week for 4 weeks and maintenance treatments as needed. Patients are required to be in office and monitored by a physician for a minimum of 2 hours during the treatments and have a safe ride home. Patients cannot drive until they have a full night’s rest.

• To start treatment, give the office a call and specifically request for a Spravato®/ketamine intake appointment or have your psychiatrist/therapist/primary care doctor fax us a referral to (888)316-7716.

WHAT DOes SPRAVATO® and KETAMINE TREATMENT LOOK LIKE?

• We strive to ensure that you have the best treatment session possible. To do this, we provide patients with a relaxing, therapeutic environment free from distractions and which is not overstimulating.

• Our expert staff will be available throughout your 2 hour in office SPRAVATO® or ketamine treatment session to ensure that you receive the care and attention you need, as well as providing pre-care instructions, safety, and post-care advice.

• Potential side effects include: increased blood pressure, nausea, sleepiness, fainting, dizziness, spinning sensation, anxiety, respiratory depression, or feeling disconnected from yourself, your thoughts, feelings, space, and time (dissociation). These side effects may occur right after treatment and typically go away the same day.

• SPRAVATO® must be taken twice a week for the first four weeks. Treatment schedules will then shift to a weekly treatment every four weeks.  Afterward, your healthcare provider will help you determine the best frequency for follow-up applications.

preparing for your treatment

• Pre-treatment preparation is one of the most important aspects of a successful SPRAVATO® or ketamine session. Coming into the clinic with an open mindset and a desire to transform negative thought patterns will aid your success. 

• Some helpful tips include bringing a book, tablet, or music with you to your session. Prepare a playlist of relaxing music that helps you get into the right mindset for treatment. Be open and honest with yourself about with objective for your session, setting your intentions for the session. 

• Prior to treatment:

  • Get a full night’s sleep the night before.

  • Set your intentions for the session.

  • Advise your healthcare provider of any medications/vaccines/alcohol you may have taken before your SPRAVATO® or ketamine treatment session.

  • Avoid eating two hours before treatment.

  • Do not drink any liquids 30 minutes before your session.

  • If applicable, nasal corticosteroids or decongestant medications, blood pressure medications, anti-nausea medications should be taken at least one hour before SPRAVATO® or ketamine treatments begin.

  • Avoid controlled medications including opioids, stimulants, controlled sleeping medications, alcohol, recreational drugs, cannabis, and benzodiazepines a minimum of 12 hours before your treatment session to prevent risks and to ensure a safe, well tolerated experience.

after your treatment

• We require that you avoid driving, have a safe ride home, avoid operating heavy machinery, avoid taking care of young children alone, and avoid using controlled medications and alcohol after your treatment until the following morning.

• Integration: We strongly recommend that patients be involved in psychotherapy and particularly, integration of the esketamine experience. Contact your provider at Sweetgrass Psychiatry to be established with a therapist to guide you in the days after your treatment session. Download a free integration workbook here: https://maps.org/integration-station/.

what is the difference between ketamine and spravato (esketamine)?

• SPRAVATO® is a ketamine-based treatment, but differs from IV Ketamine. Many people may associate ketamine with psychedelic street drugs, but the Esketamine nasal spray, SPRAVATO®, is FDA-approved and safe to use in a treatment center under the supervision of a licensed medical provider and has been proven to help people break through depression where other typical medications have not worked.

• SPRAVATO® offers better insurance coverage than ketamine.

• SPRAVATO® is a nasal spray that is very simple, easy, and painless for patients to self administer in office. Many ketamine clinics use IVs.

MEET OUR SPRAVATO® EXPERT: william (bill) rayburn md, MBA

Dr. Rayburn joined Sweetgrass Psychiatry with experience in educating and monitoring patients undertaking esketamine (Spravato) therapy.  His background and interests in new drug development, care for patients with depression, patient education, and clinical research make him a valuable addition to our group practice.  His studies in his former research laboratory dealt with long-term effects from exposure to antidepressants and antianxiety medications on the fetal brain. Dr. Rayburn is a former distinguished professor, associate dean, chair of obstetrics and gynecology, and chief of staff at the University of New Mexico in Albuquerque.  As a board certified obstetrician-gynecologist, he continues to care for underserved women with complicated pregnancies. Being a frequent invited lecturer, Dr. Rayburn is the recipient of several awards for his teaching, research, and many publications including 19 books. Current and recent past medical leadership positions have been in several national medical specialty, research, and education organizations.

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