NORTHAMPTON — ServiceNet, a leading provider of community mental-health services in Western Mass., is launching a new esketamine program at its Northampton clinic for people experiencing treatment-resistant depression. Though previously limited to those with substantial financial means, this breakthrough treatment approved by the FDA in 2019 is now covered by most insurance plans, including Medicare and MassHealth.
In depression, certain areas of the brain may be underactive, leading to symptoms such as low mood, loss of interest, and feelings of hopelessness. Esketamine helps to restore balance by promoting the formation of new connections between brain cells, known as synapses, in these underactive areas. This process enhances learning functions and eventually trains the brain to adapt to a more comfortable and positive state.
“This is the first big breakthrough in treating major depression and reducing suicidal risk since TMS [transcranial magnetic stimulation] was approved in 2008, and the evidence is fantastic,” said Dr. Katie Hershon, medical director at ServiceNet. “Some patients start seeing significant improvement within just 24 hours of the first dose, while for others, it may take a bit longer. But after the first four weeks, studies have shown that 75% of patients experience clinical benefit, and about half experience remission.”
Spravato (esketamine) is self-administered via nasal spray by the patient under supervision of a nurse at the clinic. Patients then rest for the next two hours in a relaxation lounge. The attending psychiatrist checks in with them during that period, while a nurse monitors their vital signs and addresses any temporary adverse effects, such as a rise in blood pressure or feelings of sedation.
During the first four weeks of treatment, patients come to the clinic twice a week. After that, they come for one session a week for a few weeks or until they are ready to cut back to one session every other week. Eventually, they may come in even less often, or as needed.
Like transcranial magnetic stimulation, which ServiceNet also offers at its Northampton clinic, esketamine is currently available only for those with treatment-resistant depression who have already tried at least two courses of antidepressant medication without experiencing improvement in their symptoms. Patients must also qualify through a risk evaluation and mitigation strategy program to ensure that use of the drug is an appropriate treatment option for them.
For more information about ServiceNet’s comprehensive clinical options for treatment of depression, call (413) 584-6855 or visit www.servicenet.org.