In a clinical study lasting four weeks, Spravato improved symptoms of depression in people taking the drug. One group was given Spravato and an oral antidepressant. The other group was given a placebo (no treatment) and an oral antidepressant. Depression symptoms were measured on a scale of zero to 60 (with higher scores indicating worse depression symptoms).
People taking Spravato had fewer depression symptoms than people taking the placebo; their scores improved by 4 points more than scores for people taking the placebo. The greatest improvement in symptoms was seen in the first 24 hours after people took Spravato.
After the four-week trial, some people enrolled in a year-long study. These were people who had a significant improvement in their depression symptoms during the first study.
In the year-long study, Spravato also improved depression symptoms. During this study, people were taking an oral antidepressant with either Spravato or a placebo nasal spray. Those who took Spravato were 51% to 70% less likely to relapse back to severe depression than those taking the placebo.
There are no current head to head studies comparing the effectiveness of Spravato to IV Ketamine infusions. Based on the experience of practitioners using compounded intranasal ketamine vs. IV Ketamine infusions, Ketamine infusions appear to have a more robust effect in treating depression and can also be individually adjusted to provide the effectiveness you need.
Although it is given as an intranasal spray, the FDA has highly regulated Spravato and requires that the medication either be sent by the pharmacy directly to the practitioner’s office or purchased from the practitioner’s office.
The FDA has also required that Spravato be administered in the practitioner’s office with a 2 hour post-application monitoring period in the office.
You can check with your insurance provider as to whether Spravato is a covered service for you, both the medication, application in the office /post-application monitoring period.
As it is a brand name drug, as opposed to IV ketamine which is generic, without insurance Spravato is quite expensive, however, Janssen, the company that developed Spravato, does have options for financial support for patients who need this. Janssen CarePath
The current recommended treatment protocol is for 2x a week treatment for the 1st 4 weeks, then weekly treatments weeks 5-9. Thereafter, treatment frequency is once every 1-2 weeks. Currently there are no studies of Spravato for longer than a year.