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.