esketamine/Ketamine for Treatment Resistant Depression

Esketamine Nasal Spray (SPRAVATO®)

In the Spring of 2019, SPRAVATO®  became available to patients in the US as an option for patients struggling with Treatment Resistant Depression (TRD). If you have tried two oral antidepressants at therapeutic dose and for an adequate length of time but your symptoms have failed to resolve, you may have TRD. Dr. Winderbaum Fernandez has been offering this intervention since July of 2019. As one of the first centers nationally, she has treated over 100 patients with TRD. SPRAVATO® nasal spray is taken with an oral antidepressant. It is self-administered under the supervision of our clinic. Following administration, you will remain in the comfortable and safe environment of our office for monitoring. Often improvement can be seen in as little as 24 hours following the first dose but full recovery may take up to 4 weeks. 

Interventional Psychiatry of Tampa Bay is a REMS certified SPRAVATO® (esketamine) treatment center. 
Most insurances are accepted
If you think you might be appropriate for SPRAVATO®, scheduled your consultation appointment today

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IV ketamine infusions

IV ketamine infusion therapy is not a first-line treatment for depression. Rather, it is used when antidepressant medications fail. When administered intravenously, ketamine is effective for treating anxiety combined with depression. Current treatments for suicidal thoughts and depression can take weeks to months before they take effect. Further, patients must often try several medications before finding one that brings relief. The same applies to support therapies like talk therapy, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT). TMS and ECT are both used when other traditional methods fail. Both esketamine and ketamine are now options in these cases.

Racemic ketamine, which is administered intravenously, goes directly to the patient’s bloodstream. This is called intravenous, or IV, ketamine. The treatment is a mix of two mirror-image molecules, which are called “R” and “S” ketamine. The FDA approved its use decades ago for use as an anesthetic. For patients with treatment-resistant depression, doctors are using it off-label. Administered through an IV infusion in the arm, ketamine takes effect right away, and the effects can last from days to weeks. Patients typically receive a series of six infusions over two to three weeks as part of an “induction” phase. After that, the maintenance period begins, and patients typically return for one infusion every two to six weeks.