Spravato Information for Providers

Referring patients for SPRAVATO® at Thunder Pain and Wellness

SPRAVATO® is indicated for adult patients with treatment-resistant depression (TRD) and challenging-to-treat major depressive disorder (MDD) who have not adequately responded to at least 2 different oral antidepressants of adequate dose and duration in their current depressive state.

Fax: (775) 336-6410

Click Here for the Referral Form

We understand that finding an appropriate treatment option for your patients can be complex. We are committed to partnering with your practice to provide a well-coordinated treatment experience with SPRAVATO® for appropriate adult patients. Our care team will help provide patients with a clear understanding of what to expect with SPRAVATO® treatment sessions. Our treatment center will carry out benefits investigation to ensure that you and your patients are aware of coverage and costs prior to SPRAVATO® treatment.

Indications for Treatment

  • Treatment-resistant depression (TRD) in adults.
  • Depressive symptoms in adults with major depressive disorder (MDD) with acute suicidal ideation or behavior.

Limitations of Use

  • The effectiveness of SPRAVATO® in preventing suicide or in reducing suicidal ideation or behavior has not been demonstrated. Use of SPRAVATO® does not preclude the need for hospitalization if clinically warranted, even if patients experience improvement after an initial dose of SPRAVATO®.
  • SPRAVATO® is not approved as an anesthetic agent. The safety and effectiveness of SPRAVATO® as an anesthetic agent have not been established.

Contraindications

  • Aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial and peripheral arterial vessels) or arteriovenous malformation.
  • History of intracerebral hemorrhage.
  • Hypersensitivity to esketamine, ketamine, or any of the excipients.

REMS Certification

Thunder Pain Management is Risk Evaluation and Mitigation Strategy (REMS)–certified to provide SPRAVATO® (esketamine) CIII, a nasal spray approved for use, in conjunction with an oral antidepressant, to treat TRD in adults and depressive symptoms in adults with MDD with acute suicidal ideation or behavior. The effectiveness of SPRAVATO® in preventing suicide or in reducing suicidal ideation or behavior has not been demonstrated. Use of SPRAVATO® does not preclude the need for hospitalization if clinically warranted, even if patients experience improvement after an initial dose of SPRAVATO®. SPRAVATO® is not approved as an anesthetic agent. The safety and effectiveness of SPRAVATO® as an anesthetic agent have not been established.

Because of the risks for sedation, dissociation, abuse and misuse, and suicidal thoughts and behaviors, SPRAVATO® carries a Boxed WARNING and is available only through a restricted program called the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program. SPRAVATO® can be administered only at healthcare settings certified in the SPRAVATO® REMS Program and to patients enrolled in the program. SPRAVATO® is never dispensed directly to a patient for home use.

The medical staff at our certified treatment center are trained to prescribe, dispense, and administer SPRAVATO®, and we have established processes and procedures in accordance with the REMS. A healthcare provider will provide direct medical supervision as the patient self-administers SPRAVATO® and will monitor every patient after every dose for at least two hours for resolution of sedation and dissociation and changes in vital signs.

SPRAVATO® must never be dispensed directly to a patient for home use. Additionally, all patients require transportation from Thunder Pain Management following the observation period, as they should not drive or operate machinery until the day after a treatment session, following a restful sleep.

Get Started

A more in-depth look at SPRAVATO® and its effects on treatment-resistant depression (TRD) may be found here. A link to a referral form and associated prescribing information is here — our fax is (775) 336-6410. To learn more about our treatment center and how we can work together to provide appropriate adult patients with SPRAVATO®, please contact Gina Strasser, officemanager@thunderpain.com, (775) 336-1256