Is it Hard to Get Prescribed Spravato?

When traditional antidepressants aren’t making a difference in your treatment journey, it’s hard to know what the next effective treatment may be. For individuals living with treatment-resistant depression (TRD), one treatment option that has proven effective for many is Spravato (esketamine). It is FDA-approved and works in a different way than normal antidepressants to help those not responding to the usual medication prescribed for depression. But how complicated is it to actually get prescribed Spravato?

The process of receiving a prescription for Spravato is more complex than picking up an antidepressant from a pharmacy, but it is accessible for patients who meet the criteria. 

Eligibility Comes First

Unlike antidepressants that can be prescribed after an initial visit, Spravato is used in much more limited cases, and patients are usually required to meet certain criteria before getting prescribed this treatment. To qualify, patients generally need to meet these criteria:

• Have a diagnosis of major depressive disorder (MDD)
• Show inadequate response to at least two different antidepressants
• Documentation of their past treatment history

These are set in place as Spravato is not viewed as a starting point in the treatment of depression, but instead it is intended for people who have failed treatment with typical oral medications. This can feel like a barrier for some, but it also helps to ensure Spravato is used in a situation where it’s most effective.

The Evaluation Process

If it seems you might be a good candidate for Spravato, at this point you will need a full assessment with a psychiatrist or qualified mental health professional. Typical components of an evaluation will include:

• A complete review of treatment history, including medication trials, dosages, and durations
• A mental health assessment to evaluate and confirm your diagnosis and current symptoms
• A screening for any medical issues that could affect safety, like high blood pressure or history of substance use

This process assures that Spravato is not only appropriate, but is also safe, given the circumstances of each person. Again, it may feel like more of an obstacle to treatment than simply picking up a prescription from the pharmacy, but all of this is part of ensuring the treatment is regulated, reliable and safe.

Finding a Certified Clinic

A major distinction between Spravato and other antidepressants is the fact that Spravato must be taken in treatment centers certified in the REMS (Risk Evaluation and Mitigation Strategy) program. This means:

• Spravato can’t be taken at home
• Every dose has to be administered and supervised by a trained healthcare professional
• The clinic must be equipped to monitor patients for at least 2 hours after treatment

For many patients, finding a certified clinic in their area is often just as challenging as ensuring that they qualify. Resources like MDDCare exist to help ease this burden and assist patients in finding a provider in their area that offers Spravato.

What Treatment Involves

If prescribed, Spravato will be given as a nasal spray in a certified clinic. For each session:

• Patients are monitored for at least 2 hours to monitor side effects like dizziness, dissociation, or changes in blood pressure
• Driving is not allowed after treatment, so you will need to arrange a ride home
• Treatments start with two times per week and then later taper to once per week, or less, depending on response

Although the commitment is greater than taking medication at home, many patients report feeling a greater sense of safety and structure from having in-office visits.

How Accessible is Spravato?

So, is getting prescribed Spravato hard? It depends on how you look at it. Yes, it takes more steps and more requirements than starting traditional antidepressants. But if you meet the criteria, then it’s well worth the process in order to get the treatment you need to feel better. 

For patients who qualify, Spravato is becoming increasingly available, more clinics are offering Spravato treatments, and more insurance companies are recognizing its value. After years of feeling hopeless from unsuccessful treatment and care, Spravato offers a new chance to find relief.

Take the First Step

Getting prescribed Spravato does require commitment, but it is certainly worth it. Eligible patients can work with their providers to complete the evaluation, connect with a certified clinic, and start the process of treatment.

If you’re thinking about Spravato or want to know if it’s an option for you, tools like MDDCare can help you find certified providers in your area and help you understand the next steps. Visit MDDCare.com and take the first step today!