Esketamine treatment: Information on adverse reactions, pricing, administration, and additional details
Spravato, a nasal spray medication, is predominantly utilized for the treatment of treatment-resistant depression (TRD) and major depressive disorder (MDD) in adults who have suicidal thoughts or behaviors. This brand-name drug contains the active ingredient esketamine, a derivative of ketamine, and is available only as a prescription.
The Food and Drug Administration (FDA) has approved Spravato for the treatment of TRD and MDD, which is when standard antidepressant medications have not been effective. However, doctors may prescribe Spravato for off-label use in certain situations. Off-label use refers to the application of a drug for conditions other than its FDA-approved indications.
Off-label uses of Spravato extend to psychiatric conditions where conventional treatments have limited effectiveness. One such condition is bipolar depression, though its use in this context should be approached cautiously due to limited evidence and long-term safety data [1][4].
Additionally, off-label uses of ketamine, the racemic form of esketamine, have been explored for other forms of depression beyond TRD. However, since ESPRAVATO's use is more restricted, its off-label applications in these areas are not as common [3].
Other investigational and experimental uses of Spravato include the treatment of chronic pain syndromes and potential adjunctive use alongside other psychedelic or neuromodulation therapies like transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), or vagus nerve stimulation (VNS). These uses are still under exploration and lack sufficient evidence to support routine clinical practice [4].
In summary, while Spravato is approved by the FDA for the treatment of TRD and MDD with suicidal thoughts or actions, its off-label use extends to bipolar depression and other forms of depression where standard treatments have limited effectiveness. Off-label uses for chronic pain and in combination with other psychedelic or neuromodulation therapies remain investigational and should be approached with caution.
