Spravato (Esketamine) Nasal Spray: Understanding Its Side Effects

Navigating the world of mental health treatments can feel like a journey through uncharted territory. When traditional antidepressant medications haven't quite hit the mark, doctors might consider options like Spravato, also known by its generic name, esketamine. This isn't your everyday pill; Spravato is a prescription nasal spray used to treat specific types of depression in adults, particularly treatment-resistant depression and major depressive disorder with active suicidal thoughts or behaviors. It's always prescribed alongside another oral antidepressant, offering a different approach when other treatments fall short.

Spravato is administered as a nasal spray, and crucially, you'll receive it under the direct supervision of a healthcare professional at a clinic or medical facility. This isn't something you'd use at home without guidance. The reason for this close monitoring is that Spravato, like many powerful medications, can come with a range of side effects, from the mild and manageable to the more serious and potentially concerning. Understanding these side effects is a vital part of making an informed decision about your treatment and staying safe throughout the process.

This article aims to shed light on the potential side effects of Spravato, helping you and your doctor have a more open conversation about what to expect. We'll explore the common, less common, and serious adverse reactions, along with what steps you can take if you experience them. Remember, knowledge is power, especially when it comes to your health.

Common Side Effects of Spravato

It's normal for any medication to have potential side effects, and Spravato is no exception. While not everyone will experience them, some side effects are reported more frequently than others. Being aware of these can help you be prepared and know what to look out for.

• Dizziness: This is a very common side effect. You might feel lightheaded or unsteady. It's important to remain seated or lying down after receiving your dose until your healthcare provider says it's safe to move around.
• Nausea: Feeling sick to your stomach is another frequently reported side effect. Your doctor might suggest ways to manage this, such as avoiding heavy meals before your appointment.
• Vertigo: This is the sensation that your surroundings are moving or spinning. Like dizziness, it's crucial to stay put until you feel stable.
• Sedation: Some individuals feel drowsy or sleepy after taking Spravato. This is why you cannot drive yourself home after treatment; you'll need someone to escort you.
• Increased Blood Pressure: Spravato can temporarily increase your blood pressure. Healthcare professionals will monitor this closely, especially immediately after administration.

These common side effects are often temporary and tend to lessen as your body adjusts to the medication. However, it's always best to communicate any discomfort or unusual feelings to your healthcare team.

Serious Side Effects and What to Do

While many side effects are mild, Spravato can also cause more serious reactions that require immediate medical attention. It's imperative to know the signs and act swiftly.

Respiratory Depression

One of the most significant risks associated with Spravato is respiratory depression, meaning your breathing can slow down or become shallow. Due to this risk, your doctor or the healthcare professional administering the dose will closely monitor your breathing for at least 2 hours after you receive Spravato. This monitoring includes checking your blood oxygen levels. If you experience difficulty breathing, shortness of breath, or any unusual changes in your breathing pattern, alert your healthcare provider immediately.

Increased Risk of Suicidal Thoughts and Behaviors

Like other antidepressant medications, Spravato carries a risk of increasing suicidal thoughts and behaviors, particularly in individuals aged 24 years and younger. Although Spravato is approved for adults 18 and older, this warning is critical. The risk is most pronounced during the initial months of treatment or when the dosage is adjusted. If you experience any new or worsening thoughts of harming yourself, or if your mood drastically changes, it is absolutely essential to seek help.

Here's how to get help immediately:

• Call or text the 988 Suicide and Crisis Lifeline: Reach out to 988 anytime to connect with trained counselors who offer free, confidential support 24/7. You can also chat online at 988lifeline.org.
• Text HOME to the Crisis Text Line: Text HOME to 741741 to connect with a volunteer crisis counselor for free, confidential support 24/7.
• Call Emergency Services: If you feel you are in immediate danger, call 911 or your local emergency number without delay.

Cognitive Impairment

Spravato treatment can sometimes lead to cognitive impairment. This means you might experience temporary difficulties with thinking, memory, or concentration. In clinical studies, these effects peaked about 40 minutes after a dose and typically resolved within 1 to 2 hours. Long-term cognitive impairment was not reported in studies. If you notice significant or persistent problems with your thinking, discuss it with your doctor.

Severe Allergic Reactions

Although rare, severe allergic reactions can occur. Symptoms might include swelling of the face, lips, tongue, or throat, and difficulty breathing. These are life-threatening emergencies. If you experience any signs of a severe allergic reaction, call 911 or your local emergency number immediately.

Spravato During Pregnancy

If you are pregnant, planning to become pregnant, or breastfeeding, it's vital to discuss Spravato use with your doctor. Antidepressant use during pregnancy requires careful consideration of risks and benefits. If you and your doctor decide that Spravato is the right treatment for you during pregnancy, consider enrolling in the National Pregnancy Registry for Antidepressants (NPRAD). This registry collects valuable information about the use of certain medications during pregnancy, which can help improve care for future mothers and babies. You can learn more and register by calling 866-961-2388 or visiting the NPRAD website.

Spravato Administration and Monitoring

The way Spravato is given is as important as the medication itself. As mentioned, it's a nasal spray administered in a healthcare setting. This controlled environment allows for:

• Direct Supervision: A healthcare professional is present to administer the spray and monitor your immediate response.
• Post-Dose Monitoring: You will be observed for at least 2 hours after receiving your dose. This period is critical for assessing vital signs like blood pressure and breathing, and for managing any immediate side effects.
• Safe Departure: Because Spravato can cause sedation and impair cognitive function, you absolutely cannot drive yourself home. Ensure you have a reliable plan for transportation before your appointment.

When to Consult Your Doctor

Open communication with your healthcare provider is paramount throughout your Spravato treatment. Always contact your doctor if:

• You experience any side effects that concern you, even if they seem mild.
• Your symptoms of depression worsen, or you have new or increased suicidal thoughts.
• You have any questions or uncertainties about the medication or its effects.
• You are considering becoming pregnant or are already pregnant or breastfeeding.
• You experience any unusual or severe physical symptoms.

In case of serious side effects or a medical emergency, do not hesitate to call 911 or your local emergency number immediately.

Frequently Asked Questions (FAQ)

Q1: How long do the side effects of Spravato typically last?

Many common side effects, like dizziness and cognitive impairment, are temporary and tend to resolve within a few hours after administration. However, the duration can vary from person to person. Always discuss persistent or bothersome side effects with your doctor.

Q2: Can I take Spravato if I have high blood pressure?

Spravato can increase blood pressure. If you have pre-existing high blood pressure, your doctor will carefully assess the risks and benefits and monitor your blood pressure very closely during and after treatment.

Q3: Is Spravato addictive?

Spravato contains esketamine, which is related to ketamine. While it is a controlled substance and carries risks, when used as prescribed under strict medical supervision for specific conditions, the risk of developing a substance use disorder is managed. It is not considered addictive in the same way as illicit drugs when used appropriately in a clinical setting.

Q4: What should I do if I miss a dose of Spravato?

Spravato is administered in a clinical setting, so you won't typically miss a dose in the way you might with an oral medication. If you need to reschedule an appointment, contact your doctor's office as soon as possible to arrange a new time.

Spravato offers a new avenue for individuals struggling with difficult-to-treat depression. By understanding its potential side effects and working closely with your healthcare team, you can approach this treatment with greater confidence and ensure your safety and well-being throughout the process.