HCN News & Notes

Brattleboro Retreat Introduces Esketamine Program for Treatment-resistant Depression

BRATTLEBORO, Vt. —While treatments such as anti-depressants and psychotherapy work for many people with certain psychiatric conditions, for others, these interventions can prove ineffective. When at least two medications from different drug classes have failed to provide symptom relief, adult individuals may qualify for esketamine (Spravato) therapy, now offered by referral in the Specialty Medication Clinic of the Brattleboro Retreat, a leading specialty psychiatric hospital for people of all ages located in Brattleboro, Vt.

FDA-approved, esketamine is a prescription-only nasal spray which is self-administered in a safe, medically supervised clinical setting to treat adults with treatment-resistant depression or adults with major depressive disorder with acute suicidal ideation or behavior. It increases the brain’s glutamate levels, which is thought to alleviate depression by strengthening and improving connections between brain cells.

Julie Tracy, acting Specialty Medication Clinic manager and clinician, noted that esketamine “is effective for 70% to 75% of people who receive a full treatment course, with relief sometimes coming within hours, or after several treatments, faster than many conventional antidepressants.”

She explained that qualifying patients referred by a medical or mental-health provider receive treatment twice a week for four weeks, then step down to once a week for an additional four weeks, at which point their progress is evaluated. Each session takes about two hours and 15 minutes in the Brattleboro Retreat’s Specialty Medication Clinic, from check-in to administering of the medication, with a two-hour observation period in a private room to watch for temporary side effects, including dizziness and fatigue.

To learn more about esketamine treatment at the Specialty Medication Clinic, the Brattleboro Retreat directs people to brattlebororetreat.org/smc. Those who wish to know if they qualify for this prescription-only treatment are advised to speak to their doctor or therapist, as there are currently no self-referrals for this treatment. Providers may fill out a referral form online at brattlebororetreat.org/referrals or call (802) 258-3700. Esketamine is covered by Medicare, Medicaid, and most private insurers. Verification of insurance acceptance is provided free of charge by the Brattleboro Retreat.