Ketamine IV Therapy and SPRAVATO™ for Depression at Pacific Health Systems

Depression is the leading cause of disability worldwide. While there are many therapies and medications that can help manage the symptoms of depression, they don’t work for everyone.

Studies have found that approximately one-third of people with depression are unable to find relief with standard antidepressants. Ketamine, however, has recently emerged as one of the biggest breakthrough depression treatments in decades. Fast-acting and effective, ketamine IV therapy and SPRAVATO™ nasal spray can alleviate symptoms and improve the quality of life for those who suffer from treatment-resistant depression (TRD).

What is ketamine IV therapy and how does it work to treat depression?

Ketamine first emerged as an anesthetic drug in the 1960s. Due to its dissociative and hallucinogenic side effects, it also gained popularity as a street drug. Since the late 1990s, it has been used as an off-label treatment for depression, PTSD, and other mood disorders. In March 2019, the FDA approved a ketamine derivative (esketamine) for treatment-resistant depression. Ketamine IV therapy is still considered an off-label treatment, but it has also proven effective in the treatment of TRD.

Ketamine IV therapy involves a carefully dosed infusion of ketamine administered in a healthcare facility. Unlike standard antidepressants, which take weeks to work, ketamine provides relief within hours.

Researchers are still learning exactly how it works, but it appears to induce changes in brain circuit function and stimulate synapse regrowth.

Ketamine IV Treatment Process

As a Schedule III drug, ketamine is approved for medical use but must be administered in a healthcare setting. Once it is determined that ketamine IV therapy is a suitable option for you, you’ll be given a treatment schedule determined by your provider. Typically, patients receive three IV treatments the first week, two in the second week, and then one a week for three weeks. Maintenance treatments average once a month.

The IV infusion takes approximately 90 minutes, and treatment sessions include an additional two-hour observation period, during which time you can rest while your provider monitors you for side effects. On treatment days, you’ll need to make arrangements for transportation, as you will not be able to drive or operate any heavy machinery for the rest of the day.

What is SPRAVATO™ and how does it work to treat depression?

Ketamine Depression Treatment in San Diego

SPRAVATO™ is a prescription nasal spray prescribed for adults with treatment-resistant depression. (TRD is defined as depression that has not responded to at least two antidepressants). SPRAVATO™ contains esketamine, a drug derived from ketamine, which has been used as an anesthetic drug since the 1960s and became popular as a party drug in the 1980s. SPRAVATO™ has a different molecular makeup than ketamine and contains much lower doses of the derivative than would be found in any anesthetic or club drugs.

Studies have shown that when used in combination with an oral antidepressant, SPRAVATO™ begins to improve symptoms of depression within a few hours. Most oral antidepressants work by changing levels of chemicals in the brain that affect mood and emotion, a process that usually takes weeks to start working. SPRAVATO™ is thought to work differently, although it is unclear exactly why or how it works. Depression is a complex condition, and there is still so much unknown about its exact causes, and why some treatments work better than others.

SPRAVATO™ Treatment Process

SPRAVATO™ is prescribed in combination with an oral antidepressant and administered under the direct supervision of a healthcare provider. SPRAVATO™ is classified as a Schedule III drug, which means the FDA has approved it for medical use but it also has a high risk of misuse and dependence, so laws govern how it is dispensed and administered. SPRAVATO™ is only available to patients enrolled in the SPRAVATO™ Risk Evaluation and Mitigation Strategy (REMS) program at a certified SPRAVATO™ treatment center.

Your first visit to our SPRAVATO™ treatment center will involve evaluation and assessment to confirm that SPRAVATO™ is a suitable option for you. During this time, your provider will explain the process, answer questions, and otherwise prepare you for your subsequent treatment sessions. Treatment does not usually take place on the first visit.

On treatment days, you’ll need to make arrangements for transportation, as you will not be able to drive or operate any heavy machinery for the rest of the day.
At your treatment sessions, you will administer the SPRAVATO™ nasal spray under the supervision of your provider and then remain at the treatment center for two hours of observation. This gives you the opportunity to rest while your healthcare provider monitors you for side effects. You can bring items, such as books, headphones, a journal, or a media tablet to keep you restfully occupied during the observation period.

Treatment sessions will take place twice a week during the first month, once a week during the second month, and then once a week or once every two weeks thereafter. You will continue to take your oral antidepressant medication as prescribed.

Who qualifies for ketamine IV and SPRAVATO™ treatment?

Ketamine is prescribed for treatment-resistant depression.

The best candidates for ketamine:

  • Have been unresponsive to two or more antidepressant medications
  • Are at least 18 years of age
  • Are not allergic or hypersensitive to ketamine
  • Are not pregnant or breastfeeding or planning to breastfeed or become pregnant
  • Do not have a history of:
    • Hypertension
    • Cardiovascular disease
    • Bleeding in the brain

Before beginning ketamine treatment, it’s important to discuss all health issues with your provider. These include but are not limited to a history of stroke, liver problems, psychosis, or drug or alcohol abuse.

What are the side effects of Ketamine IV and SPRAVATO™?

Ketamine IV therapy and SPRAVATO™ are well-controlled and carefully dosed to minimize the drug’s side effects. But there are some potential mild and temporary side effects, including:

  • Dissociation (floating sensation,  disconnection from yourself, your thoughts, and your feelings)
  • Drowsiness
  • Elevated heart rate
  • Elevated blood pressure
  • Nausea

Side effects typically wear off within two hours.

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Ketamine IV therapy and SPRAVATO™ for treatment-resistant depression at Pacific Health Systems

If you suffer from symptoms of depression that have not responded to antidepressants and other therapies, ketamine IV therapy and SPRAVATO™ may be able to relieve your symptoms and restore your quality of life.

For more informationon ketamine depression treatment, call (619) 631-0153 today.

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