New hope for patients suffering from treatment resistant depression has arrived in the form of Spravato (esketamine nasal spray), a novel way of treating depression as compared to standard treatments. Whereas a majority of patients receiving treatment for depression via antidepressant medications and/or psychotherapy, up to one-third of patients can be classified as being "treatment resistant", which is defined as not having achieved a response or remission of symptoms with at least two antidepressant medications. For many of those people, depression can be debilitating, and for some of those, leading to suicidal ideation and even suicide attempts. For this subset of patients, inpatient hospitalization or electroconvulsive therapy (ECT) were seen as the only possible options for help. Enter ketamine.
Long used as in the world of anesthesia, ketamine earned a bad reputation due to it's illicit use as a hallucinogenic and dissociative agent, becoming popular amongst club goers and on the streets. Along the way however, it became apparent that there was some antidepressant property to it, especially in those who were suicidal. Research over the years showed that small doses of ketamine given in a controlled environment were showing tremendous results for depression and suicidality. In recent years, it became popular in infusion centers and was being used off-label for treatment of depression. In March 2019, the FDA approved a nasal spray formulation of esketamine, which is a part of ketamine, with the brand name Spravato for treatment resistant depression. Due to potential for abuse that still exists, only certain healthcare settings and physicians are authorized to prescribe and administer it; luckily, Dr. Mirza and LouCouPsych are set up and certified, and currently is the only facility in Loudoun County where it is available.
For those interested, Dr. Mirza is accepting patients for this new, exciting, and hope-providing treatment. Most insurance companies do cover the cost of the medication based on certain qualifiers, with there also being a $10 savings card available through the manufacturer. Due to the additional restrictions and regulations, as well as the required monitoring period associated with in-office administration, there is a very specific pricing schedule in place:
Initial assessment appointment is $150
Administration and observation appointments are $250
The first 4 weeks requires 8 twice-weekly appointments, with a pre-payment option of $1800 (saving $200)
The second 4 weeks requires 4 once-weekly appointments, with a pre-payment option of $900 (saving $100)
Scheduling after that is every 1-to-2 weeks, depending on response
Superbills for submission to insurance companies will be provided for all visits as requested. For more information and to take the next step in your road out of depression, please message us using the widget below, or via email or phone.