Clark Memorial Health offers new medication for treatment-resistant depression

March 4, 2020

A new treatment is providing hope for people with persistent depression. Clark Memorial Health is among the first facilities in Indiana to offer Spravato, a nasal spray medication that patients are describing as “life-changing.”

Spravato is designed to treat depression that has resisted other treatments and differs from most commonly used antidepressants by targeting a different neuroreceptor in the brain. A derivative of the drug ketamine, Spravato has been in development for 10 years with clinical studies revealing effectiveness when

taken alongside an oral antidepressant. It was approved by the FDA in March 2019.

Patients come to a certified treatment center to receive the medication, are monitored for two hours afterward, and must have a ride home available. Treatments start out twice a week and decrease gradually over the course of a year. But patients can start to see results in as little as one to three treatments, says Clark’s clinical program manager Cindy Little.

“This is honestly the first medication I’ve seen work the way it does and as quick as it does,” she says. “It’s not a forever treatment.”

Patient Tracy Bedan was diagnosed with bipolar one when she was 18 and has tried different kinds of medication over the years. She says she was in a very dark place last June.

“I didn’t care if I lived or not,” Bedan says. “I didn’t want to leave the house. I felt really insecure and horrible, horrible anxiety and depression.”

Bedan says she was skeptical of trying another medication after hearing about Spravato in group therapy at Clark’s Behavioral Health unit. But after two weeks of treatment, she felt different.

“It was like an ‘Aha’ moment after about four treatments,” she says. “I was able to get out of bed, get dressed, put on makeup and feel good about myself to where I could leave the house. I couldn’t have done that five or six months ago.”

Bedan has since returned to work in Jeffersonville. She’s been able to interact with friends and recently attended an Indiana University basketball game. Now she’s planning to go on a cruise in July.

“[Spravato] has just been a life-changer for me,” she says. “It’s been a miracle.”

Dissociation, or feeling disconnected or sedated, is the most common side effect of Spravato. But Little and Dr. Asad Ismail, director of Clark’s Behavioral Health program, say they’ve seen few side effects in Spravato patients.

“It is very fast-acting, and there is no chance of abusing it as it is given by a provider,” Dr. Ismail says.

Many patients are referred for Spravato, but Dr. Ismail says people who are interested may contact Clark’s intensive outpatient therapy program for an assessment. Factors for candidacy include how long a patient has experienced depression, what types of and how many medications the patient has tried, and whether the patient has any history of substance abuse.

A few medical exclusions apply to people who have blood vessel (aneurysmal vascular) disease, have an abnormal connection between veins and arteries, have a history of bleeding in the brain, or are allergic to any ingredients in Spravato.

There is a copay assistance program to help patients with the cost of the treatment.

Rachel Renfrow is another patient who has experienced a transformative effect since starting Spravato treatments. She has battled depression and addiction since the loss of her mother when Renfrow was a teenager.

“The difference [Spravato] makes in your life is almost like a brand new person,” Renfrow says. “It’s the me I knew when I was 18, when I was happy, when I was vibrant, when I was excited about doing things in life.

“People need to know that this med works,” she finishes. “It works. It's life-changing and it makes a huge difference, a huge, huge difference.”

Contact Clark Memorial Health’s intensive outpatient therapy program by calling 812.283.2765. The Behavioral Health unit also has a 24-hour crisis hotline: 812.283.2811.