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Major Depressive Disorder with Suicidal Thoughts or Actions (MDSI) | SPRAVATO® (esketamine) Nasal Spray
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SPRAVATO®: proven effective for depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions (MDSI)

Limitations of Use:

SPRAVATO® is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO® is safe or effective as an anesthetic medicine.

It is not known if SPRAVATO® is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. SPRAVATO® is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of SPRAVATO®.

It is not known if SPRAVATO® is safe and effective in children.

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You may benefit from adding SPRAVATO® to your existing
oral antidepressant.

In clinical studies of adults with MDD with suicidal thoughts or actions, those who took SPRAVATO® and an oral antidepressant experienced a greater reduction of depressive symptoms at 24 hours compared to those who received a placebo plus an oral antidepressant.*

*Based on an overall score on a standardized rating scale.

Further reductions were seen consistently through four weeks (25 days) of treatment, so it is important to follow the treatment plan that you and your healthcare provider have made. Not all patients will respond to SPRAVATO®.

SPRAVATO® Safety

Serious side effects of SPRAVATO® include feeling sleepy (sedation or loss of consciousness) feeling disconnected from yourself, your thoughts, feelings and things around you (dissociation); breathing problems (respiratory depression and respiratory arrest); abuse and misuse; increased risk of suicidal thoughts and behavior; increased blood pressure; problems with thinking clearly and bladder problems.

The most common side effects that can occur during and after taking SPRAVATO® include:

  • Dissociation
  • Dizziness
  • Nausea
  • Sedation
  • Spinning sensation
  • Numbness
  • Feeling anxious
  • Lack of energy
  • Increased blood pressure
  • Vomiting
  • Feeling drunk
  • Feeling very happy or excited

If SPRAVATO® side effects occur, they usually happen right after taking SPRAVATO® and go away the same day

Less than 7% of patients stopped SPRAVATO® treatment due to side effects in short- and long-term clinical studies.

These are not all the possible side effects of SPRAVATO®. Please see the SPRAVATO® Medication Guide for the complete safety information.

To help ensure your safety, SPRAVATO® has a program called SPRAVATO® REMS (Risk Evaluation and Mitigation Strategy), which requires close monitoring of safety

Because of the risks for sedation or loss of consciousness, dissociation, respiratory depression and abuse and misuse, SPRAVATO® is only available through a restricted program called the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program. SPRAVATO® can only be administered at healthcare settings certified in the SPRAVATO® REMS Program. Patients treated in outpatient healthcare settings (e.g., medical offices and clinics) must be enrolled in the program.

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There’s an increased risk of suicidal thoughts and actions with SPRAVATO®

Call your healthcare provider right away if you have new or sudden changes in mood, behavior, thoughts or feelings, or if you develop suicidal thoughts or actions.

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Help is available 24/7. If you’re struggling with suicidal thoughts, call 988 Suicide & Crisis Lifeline

Help is available 24/7. If you’re struggling with suicidal thoughts, call 988 Suicide & Crisis Lifeline

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SPRAVATO® Dosing for MDSI

After you and your healthcare provider have decided SPRAVATO® is right for you and you understand the benefits and risks, you can start planning for treatment.

  • You’ll administer SPRAVATO® nasal spray yourself under the supervision of a healthcare provider in a certified SPRAVATO® treatment center
  • SPRAVATO® is taken twice a week for four weeks, along with an oral antidepressant
  • After four weeks, you and your healthcare provider will determine if continued treatment with SPRAVATO® is necessary
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SPRAVATO® MDSI Patient Brochure

The SPRAVATO® Patient Brochure is a helpful resource to learn about SPRAVATO® and depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions (MDSI).