For years, the Delray Center for Integrative Medicine has been one of the leading providers in outpatient depression treatment in Palm Beach and all of Florida. DCIM became one of first providers in the United States certified to provide Spravato (esketamine) nasal spray for treatment-resistant depression. The esketamine nasal spray is an FDA-approved medication meant for patients who are already taking antidepressants but are experiencing depressive symptoms. If you are struggling with treatment-resistant depression, it is important to schedule an appointment with a certified Spravato psychiatrist to determine if you are a candidate for the medication. You may also qualify for other depression treatments, such as TMS therapy or outpatient mental health intensive outpatient, which can be done in conjunction with esketamine treatments.
Esketamine, sold under the brand name Spravato, is a fast-acting medication that can alleviate severe depression. The medication comes as a single-use nasal spray and is meant to be taken along with conventional antidepressant medications. Esketamine is a form of Ketamine, a form of anesthesia with a successful track record of treating major depressive disorder when administered at lower doses. Ketamine is a racemic mixture of mirror image molecules, meaning it has two chemical forms, each being a mirror image of the other. Esketamine (Spravato) comprises just one of these chemical forms, the left sided enantiomer or “S” form. So Esketamine has some of the antidepressant properties of normal Ketamine.
Unlike Ketamine, which is typically administered in an IV or subcutaneous infusion, Esketamine is delivered into the bloodstream through the mucus membrane by way of a nasal spray. Both medications are remarkable in that they yield a rapid response, reducing or eliminating symptoms of depression almost immediately. When administered as a proper induction protocol, they both have a long-term, powerful antidepressant effect lasting weeks or months. Esketamine, like Ketamine, must be administered at a certified healthcare facility, under the watch of a trained medical professional. Patients receiving Spravato must remain in observation after taking the medication in case of any side-effects. Side-effects can include dizziness, nausea, or sedation and occur in a small number of recipients. The Spravato induction process is twice weekly administration of the medication for the first four weeks, with the option for additional treatments weekly or biweekly afterwards.
While Esketamine and Ketamine are powerful tools in combatting treatment-resistant depression, they are most effective when paired with other depression treatment therapies. Individuals interested in the Esketamine nasal spray must receive a comprehensive psychiatric evaluation to ensure there are no contraindications for use. A depression-focused doctor, like the ones at the Delray Center for Integrative Medicine, may recommend staying on or adjusting other medications to improve your overall treatment outcome. Individual and group therapy is also recommended to provide additional support and teach emotional regulation strategies to deal with any remaining depressive symptoms. Additional therapies, like deep transcranial magnetic stimulation (dTMS) can be paired with Ketamine or Esketamine because it does not interfere with existing medications in your system.
Patients with the highest success rates combine their Esketamine treatment with a partial hospitalization (PHP) or intensive outpatient (IOP) program. All of these services can be completed on an outpatient basis to avoid inpatient hospitalization and the interruptions to life that incurs. Your doctor may also recommend exercise, yoga, a vitamin regiment, or nutritional therapy to improve your chances of success. If you are interested in scheduling an assessment for Spravato, contact us today to set up an initial appointment.
“Dr. Rodriguez has created a place that is truly focused on healing. There are so many types of treatment options and they are focused on finding the one that is right for you.”
“This center is a very special place. Everyone is warm, caring, supportive, and professional. It helped me overcome my anxiety and depression. I love the emphasis on mindfulness, yoga and exercise as well as traditional therapy”