Ketamine

Ketamine is the generic equivalent of Spravato.  It has been used as an off-label treatment for depression for a number of years with excellent efficacy.  However, until now ketamine was available only as an intravenous (IV) treatment.  Spravato is a nasal spray with a novel delivery mechanism that provides precise dosing without the need for an IV.  This provides a simpler, more comfortable option for patients who are suffering from depression.  

Spravato has a novel chemical mechanism of action.  Traditional antidepressants work by augmenting the levels of serotonin, norepinephrine, or dopamine in the brain through what is known as reuptake inhibition.  Spravato works on a completely different neurochemical system.  It is known as an NMDA-receptor antagonist which regulates glutamate, a neurotransmitter distinct from those previously targeted by antidepressants.  

Ketamine can cause feelings of euphoria and dissociation.  It can also cause sedation and a temporary increase in blood pressure (on average 10 points).  For these reasons Spravato has to be administered in a doctor’s office that has been certified by the FDA mandated monitoring program for the medication.  IBH is an FDA REMS certified treatment center.