Major depression is a widespread mental health disorder affecting millions of people around the globe, impacting over 20 million adults and adolescents in the United States alone.

While depression is generally treatable, achieving significant and lasting symptom relief often requires time and patience. Conventional treatment approaches fall short of providing sufficient and enduring relief for around one-third of adults with major depression.

At Bespoke Treatment, our team of mental health experts specializes in addressing persistent depression. We are committed to offering innovative and scientifically proven solutions for patients who have not experienced success with traditional methods.

One such breakthrough is Spravato™, an esketamine nasal spray recently FDA-approved to assist individuals with treatment-resistant depression (TRD). Here’s what you should know about it.

How ketamine treats depression

Ketamine, an FDA-approved anesthetic with a history of use in surgery rooms, veterinary clinics, and battlefields spanning nearly five decades, gained recognition for its significance when the World Health Organization (WHO) added it to its list of essential medicines in 1985.

As the new millennium approached, researchers embarked on an exploration of ketamine as a potential antidepressant. Their findings held promise. Ketamine’s mode of action involves binding to NMDA receptors in the brain, encouraging the rapid activation of glutamate—a neurotransmitter pivotal in initiating crucial brain circuits that influence mood and behavior.

While traditional antidepressants also stimulate glutamate, their approach is entirely different. Over the course of a few weeks, these medications accumulate in your system and trigger a class of neurotransmitters known as monoamines (serotonin, norepinephrine). It is these newly activated neurotransmitters that subsequently bind to NMDA receptors, initiate glutamate transmission, and elevate mood.

Ketamine stands out because it operates directly on NMDA receptors and glutamate so its effects are remarkably fast and dramatic, with most individuals experiencing substantial symptom relief within a matter of hours.

The evolution of esketamine for depression

Ketamine consists of two mirror-image molecules: “R” ketamine and “S” ketamine. When used off-label to treat depression, it is administered intravenously through a bloodstream infusion.

In contrast, Esketamine exclusively comprises the “S” ketamine molecule. As an FDA-approved remedy for persistent depression, it takes the form of a nasal spray.

In March of 2019, the FDA approved Spravato, the brand name for the esketamine nasal spray, as a treatment for major depression. This groundbreaking treatment is the first of its kind and represents the sole FDA-approved NMDA receptor antagonist for managing persistent depression in adults.

Where to access esketamine

When the FDA’s announcement heralded the approval of this innovative fast-acting nasal spray to address persistent depression in adults, it gave hope to those who have failed to find relief from traditional treatments.

However, it’s important to note that obtaining a prescription for Spravato and casually picking it up at your neighborhood pharmacy is not an option. The FDA, in granting approval for esketamine to treat major depression, has issued strict guidelines on the administration of this particular medication.

While ketamine does provide immediate cognitive and mood-altering benefits for those living with depression and other mental health conditions, ketamine can also induce sedation and dissociation when taken in large doses or incorrectly. In fact, this is why ketamine gained popularity as a recreational substance among club goers in the 1990s.

Due to the potential risks associated with sedation, dissociation, and misuse, Spravato is exclusively accessible through a controlled distribution system regulated by a Risk Evaluation and Mitigation Strategy (REMS).

So what does this mean for you? It implies that, even though ketamine can be self-administered, it must be taken under the supervision of an experienced physician within an authorized medical facility.

A certified ketamine treatment facility

At Bespoke Treatment, we take pride in being the first clinic of its kind in southern California and Las Vegas offering ketamine infusion therapy and Spravato esketamine nasal spray treatments to eligible patients.

While administering Spravato is a brief process, each esketamine treatment spans approximately two hours from beginning to end. The majority of this time is dedicated to closely monitoring your response to the medication and ensuring your safety, especially if you encounter mild hallucinations, dizziness, or vertigo.

Following the ketamine treatment you won’t be in a condition to drive until the following day after a restful night. To receive a ketamine treatment at our clinic, you must arrange for someone else to transport you to and from your treatment.

If you or a loved one is struggling with persistent depression, you are not alone. At Bespoke Treatment, we are here to help. Reach out to your nearest Bespoke Treatment facility in Los Angeles or or Las Vegas today, or alternatively, utilize our online booking system to schedule an appointment with one of our skilled ketamine specialists at your convenience.

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