A study suggests that after the third oral antidepressant, remission rates dropped below 14%. If you’ve tried two or more oral antidepressants and are still experiencing depressive symptoms, you may have treatment-resistant depression, and it may be time for something different.

Treatment-resistant depression is defined as not responding to two or more antidepressants of adequate dose and duration. If your doctor has diagnosed you with treatment-resistant depression, you may benefit from treatment with a different kind of medication.

It is important to understand the potential side effects of any medication you consider taking. To help ensure safety, SPRAVATO® is available only through a restricted distribution program called the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program.

The number of SPRAVATO® treatment sessions the healthcare provider recommends depends on a variety of factors. In general, patients receive two doses of SPRAVATO® each week in separate sessions. After the first several weeks, the healthcare provider may reduce the number of sessions to one per week.

SPRAVATO® (esketamine) CIII nasal spray is a derivative of ketamine. SPRAVATO® is an FDA-approved nasal spray for treatment-resistant depression; it is also approved to treat depressive symptoms in adults with major depressive disorder with suicidal thoughts or actions. Ketamine has not been approved by the FDA to treat depression. Both SPRAVATO® and ketamine are Schedule III controlled substances under the US Controlled Substances Act.

There is no evidence to suggest that SPRAVATO®, which is used carefully in appropriate doses within a supervised facility, leads to dependence (or addiction) to the substance. With that said, there are ties to ketamine that are used for recreational purposes and can be addictive when taken irresponsibly, so it is important to avoid ketamine use outside of a supervised facility.

Before starting SPRAVATO®, tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking SPRAVATO® with certain medicines or alcohol may cause side effects. Especially tell your healthcare provider if you take central nervous system (CNS) depressants, psychostimulants or monoamine oxidase inhibitor (MAOI) medicine. If you use a nasally administered medication like a nasal steroid or decongestant spray, do not administer it within the hour before you will be taking SPRAVATO®.

SPRAVATO® can fall under the medical or pharmacy benefit depending on your coverage, so it’s important to ask and relay this to your healthcare provider.