So today I’m going to review Spravato, the new to antidepressant nasal spray approved by the FDA only two weeks ago.
This drug makes me very, very happy, and it makes me very, very scared.
Spravato – the Launch
So out of the blue, 6 weeks ago I woke up to the news that the FDA have granted a license to a new antidepressant medication, called the Spravato, based on Ketamine, and this made me very happy on one hand and very scared on the other hand.
The Good
Let me tell you first why it made me very happy.
Spravato is a treatment for “treatment resistant depression”.
This is a type of depression where people basically do not respond to any of the conventional treatments they try.,
In America alone, there are 16.2 million people with depression. That’s 6.7% of the entire population of the country, and a third of those people do not respond to any of the treatments offered to them.
They are classified as having treatment resistant depression, and it’s one of the most horrible things to comprehend, to know that you are depressed. You have a diagnosis of depression, but your psychiatrist just turns around and says, “Sorry, sorry mate, there’s nothing else I can give you. You’ve tried everything.”
I mean, that is like staring into the abyss.
So thankfully, this medicine will prove a tremendous option, a real godsend for people with this type of a depression, and that really, really makes me very happy.
By the way, if you have been diagnosed with depression and you’ve tried at least two different drugs, you maximised the dose of those drugs, you’ve tried them for long enough, then you are defined as having treatment resistant depression.
At that point you can go for Spravato. And not before that.
So don’t think that this is a drug that you can just go quickly tomorrow, ask your a psychiatrist and they’ll just write it for you.
No!!
you have to have tried all the other treatments available, at least two of them.
How Quickly Spravato nasal spray works
The other reason it makes me very happy is because it works so fast.
The literature says it works in as little as one day, in 24 hours.
I think more realistically, it might be a week or maybe five days, but even that is incredible, because the current treatments, treatments like Prozac and all the common treatments for depression, they take weeks.
You have to wait four to six weeks for those treatment to fully kick in. So this is amazing news for people with depression, who want to get better as soon as possible.
Restricted Prescribing of Spravato
A third reason why it makes me happy is because it’s incredibly restricted. So the supply of this is only through certain psychiatrist.
When a patient enrols to take this medication, they have to kind of sign a form, and the psychiatrist signs a form.
I think they have to take it in the psychiatrist’s office. They have to be monitored for at least two hours afterwards. So there’s incredible restriction on the use and possession of this drug, and that makes me very happy. The reason for that would make sense later. So hang around.
THE BAD
Side effects
Now let’s move on to why this new drug makes me very scared. Number one is the side effects.
So this drug is based on Ketamine. You might think, hmm, Ketamine, that rings a bell.
if you were a little party boy or a party girl back in the ’80s and ’90s, there’s a good chance you tried this. This was a huge party drug. Hallucinogenic and people took it by the bucket-load.
They just wanted that euphoria, that feeling that they were walking on the moon, that lightheartedness, and it was a really, really popular recreational drug back then.
This Spravato is based on this very drug.
Another way Ketamine is used is as an anaesthetic, as a horse tranquilliser.
The side effects can be incredibly deadly, if you don’t use it properly.
So if you overdose on Ketamine, you are pretty much finished, because it basically shuts down your respiratory centre, and you quickly lose consciousness.
At low to moderate doses, it has a pain killing effect. Obviously, it has an antidepressant effect too. It gives a little bit of euphoria, but it still impairs your motor skills. So obviously, when you take this you won’t be able to drive cars or operate machinery. You are pretty much out of action.
This drug has to be used incredibly carefully.
Another reason why I’m really worried about this drug, especially the long term side effects, is because this drug was rushed through. It did not go through all the trials that a normal drug goes through before being marketed and given a license.
The FDA even say in their press release that they’ve rushed it through.
Basically, it’s a drug for an area of medicine where there are few alternatives. i.e treatment resistant depression. There’s not many options to treat this.
So they used that logic to rush this drug through, saying that,
“You know what? There’s not many treatments available for that condition. So we really need to make the most of this new, innovative treatment and rush it through clinical trials.”
So how much do we know about the longterm side effects? Probably not much.
By the way, if you are a pregnant woman or thinking of using this, forget it.
You’re not going to have this drug! It’s too dangerous.
If you are a woman on this drug, you have to take extreme precautions in terms of contraception, because this drug can be very dangerous in pregnancy.
Potential for abuse
The second reason why this makes me very scared is the potential for abuse.
I am convinced that this drug is going to have a massive, massive street value, because think about it. Would a user, or potential user, would they buy something of the street? which they buy in a street corner, or would they buy something that has a license, that is clean, that doesn’t contain anything nasty?
Of course, they’re going to go for the licensed, safe option, even if that means they’re paying extra.
So this is probably going to open up a whole new front, in terms of sellers and users and people who want to make money of this, horrible people. So that really, really worries me.
Cost of Spravato
By the way, did I mention the cost of this drug?
$900 for one treatment cycle. $900, massively expensive.
Conclusion
If you start it, good luck with it. I hope it works for you. If you have already tried it, maybe there’s somebody out there that tried it in the last two weeks, leave a comment in the section below.
I think Spravato will prove extremely useful for some people. But i fear the cost and the prescribing restrictions around it, will make this a drug for the rich.
If you have depression and you’ve tried other treatments, leave a message in the comments below. Tell us your experiences.
Take care.