Spravato, also known by its generic name esketamine, is a nasal spray medication that has gained attention for its potential benefits with treatment resistant depression and suicidal thoughts. Spravato was approved by the United States Food and Drug Administration (FDA) in 2019, and it offers a novel approach with promising results in clinical trials. This article provides a comprehensive overview of Spravato, discussing its FDA-approved uses, benefits of use, potential side effects, and the Risk Evaluation and Mitigation Strategy (REMS) protocol associated with its administration.
FDA Approval and Indications:
The FDA approved Spravato for two main indications: treatment-resistant depression (TRD) and major depressive disorder (MDD) with acute suicidal ideation or behavior. It is intended for use in conjunction with an oral antidepressant and under the supervision of a healthcare professional, most commonly a psychiatrist. This approval marks a significant development in the treatment of depression, particularly for patients who have not responded adequately to traditional antidepressant therapies.
Benefits of Use:
While Spravato holds promise as a treatment option, it is important to be aware of potential side effects. Common side effects associated with its use include:
Due to the potential for abuse, misuse, and adverse effects, Spravato is subject to a Risk Evaluation and Mitigation Strategy (REMS) protocol. The REMS protocol aims to ensure safe and appropriate use of the medication and includes the following elements:
Once a patient has attended an initial consultation, your doctor will assess your condition and review your medical history. If Spravato is an appropriate treatment option for you, a personalized treatment plan will be developed based on your specific needs. Blood work will be done if necessary and followed up by staff. The treatment plan will outline the frequency and duration of your Spravato sessions. Typical treatment plans include 8 Spravato treatments over four weeks. During the initial start period, 2 doses will be administered 48-72 hours apart. After 4 weeks, 1 treatment per week followed by 1 treatment every 1-2 weeks as needed for maintenance.
To prepare for your Spravato administration:
Upon arrival at Mynd Psychiatry, patients will receive a blanket and eye mask. Patients will be guided to the treatment room filled with relaxing chairs and footrests, low lighting, and peaceful music. This room is designed to allow patients an opportunity to relax and reach full immersion of Spravato while under the supervision of a healthcare professional. Patients will be encouraged to close their eyes and place the eye mask over their eyes during treatment to reach maximum immersion. A healthcare provider will be monitoring the room and available at all times for any needs patients may have.
Spravato is self administered under the supervision of a healthcare provider. The healthcare professional will instruct you on the proper technique for using the nasal spray and guide patients through the process.
Tips for administration:
During and after each Spravato treatment session, you will be closely monitored for any potential side effects or adverse reactions. The healthcare provider will observe you for at least two hours after administering the medication to ensure your safety. During this time patients will be encouraged to engage in Cognitive Behavioral Therapy exercises to improve mental health symptoms. Cognitive Behavioral Therapy has many benefits and can improve treatment outcomes when combined with Spravato.
Cognitive Behavioral Therapy:
Cognitive Behavioral Therapy (CBT) is a widely used and evidence-based form of psychotherapy that focuses on the relationship between thoughts, emotions, and behaviors. It has been found effective in treating a range of mental health conditions. CBT helps individuals become aware of their negative or distorted thoughts and beliefs, known as cognitive distortions. Through therapy, individuals learn to challenge and reframe these thoughts, replacing them with more realistic and balanced thinking patterns.
CBT equips individuals with a wide range of coping skills and techniques that can be used in real-life situations. These skills include problem-solving, stress management, relaxation techniques, assertiveness training, and effective communication, enabling individuals to navigate challenges and improve their overall functioning. CBT is a focused therapy that helps individuals target specific problems and challenges they are facing. It provides practical tools and techniques to address these issues directly, helping individuals make tangible progress and achieve their desired outcomes.
CBT is known for its effectiveness in preventing relapse in many mental health conditions. By learning to recognize early warning signs and applying coping skills, individuals can better manage stressors and minimize the likelihood of a recurrence of symptoms. This process can lead to reduced emotional distress and improved coping mechanisms. It's important to note that while CBT has numerous benefits, different individuals may respond differently to therapy, and the effectiveness of CBT can vary.
Spravato nasal spray, or esketamine, represents an innovative treatment option for individuals struggling with treatment-resistant depression and major depressive disorder with acute suicidal ideation or behavior. Its FDA approval has brought new hope for patients who have not responded well to traditional antidepressant therapies. While offering rapid symptom relief, it is crucial to consider the potential side effects associated with Spravato and to adhere to the REMS protocol to ensure safe and appropriate use.
How do I get rid of nightmares
Image Rehearsal Therapy (IRT) is a treatment approach for individuals who experience recurrent nightmares. This therapy technique was first introduced by Barry Krakow, MD, and colleagues in the late 1990s. The goal of IRT is to reduce the frequency and intensity of nightmares by helping individuals to rewrite the script of their nightmares through the use of mental imagery and visualization.
IRT involves several stages, including education about nightmares and the IRT process, identifying the content and themes of the nightmares, and creating alternative endings to the nightmares. The therapy may be conducted individually or in a group setting, and typically lasts for 8 to 12 sessions.
During the initial phase of IRT, the therapist educates the individual about the nature of nightmares and their impact on sleep quality and overall functioning. The therapist also explains the IRT process and how it can help to reduce the frequency and intensity of nightmares.
Next, the individual is asked to keep a dream diary or a nightmare log. This allows them to track the frequency and content of their nightmares. The therapist will use this information to help the individual identify the themes and content of their nightmares.
In the next phase of IRT, the individual is asked to choose one nightmare that they would like to work on. The therapist will help the individual to create a detailed description of the nightmare, including the sensory details and emotions that are associated with it.
Once the nightmare has been identified and described, the individual is asked to create a new ending to the nightmare. This is done through the use of mental imagery and visualization. The individual is asked to imagine a different outcome to the nightmare, one that is more positive and less frightening.
The new ending should be detailed and specific, and should include sensory details and emotions. The individual should practice visualizing the new ending to the nightmare several times a day, preferably before going to bed.
Finally, the individual is asked to rehearse the new ending to the nightmare in their mind just before going to sleep. This is done to reinforce the new ending and to help the individual feel more confident and in control.
Research studies have shown that IRT can be an effective treatment approach for individuals with recurrent nightmares. One study found that IRT was more effective than other therapies, such as Imagery Rehearsal Therapy without the cognitive component or Relaxation Therapy. Additionally, a meta-analysis found that IRT was effective in reducing the frequency and intensity of nightmares in both children and adults.
IRT is a non-invasive and relatively simple therapy technique that can be effective in reducing the frequency and intensity of nightmares. However, it is important to note that IRT may not be appropriate for everyone. Individuals with severe mental health issues or a history of trauma may require more intensive therapy approaches.
In conclusion, Image Rehearsal Therapy is a treatment approach for individuals who experience recurrent nightmares. The therapy involves education about nightmares and the IRT process, identifying the content and themes of the nightmares, and creating alternative endings to the nightmares through the use of mental imagery and visualization. IRT is a non-invasive and relatively simple therapy technique that can be effective in reducing the frequency and intensity of nightmares. However, it may not be appropriate for everyone, and individuals with severe mental health issues or a history of trauma may require more intensive therapy approaches. If you are experiencing recurrent nightmares, it is important to seek professional help to determine the best treatment approach for you.
It has been found that there is a strong correlation between the power of positivity and its effect on exercise. The way you think during your exercise can impact the workout and your overall health. Positivity can boost your self-awareness and assessment of your progress during exercise. Through positivity, one may be able to achieve one's fitness goals, and increase one's overall happiness. Positivity during exercise can also improve self-esteem for individuals struggling with body image and confidence. There are many techniques one can implement into their exercise routine to improve positivity and exercise outcomes.
A way to bring positivity to your exercise is to take a moment of mindfulness before beginning the workout. During this moment, try to tune out the negative comparisons or harsh thoughts you commonly have while exercising. Bring your attention to your fitness goals and your motivation for achieving these goals. Instead of comparing your exercise routine or body image to those around you, focus on using positive self-talk to improve your fitness accomplishments. Establishing on-going positive self-talk can be done through making encouraging, positive statements towards yourself throughout the exercise routine. For example, if you are lifting a heavier weight than usual; say to yourself "I am strong and powerful". Consistent positive self-talk can convince your body and mind that you can complete a difficult workout, increase your endurance or even lift heavier weights. Staying positive can be difficult, yet through using self-talk you are able to encourage yourself while staying motivated.
Another way to bring positivity to your exercise is through challenging your negative thoughts experienced during the workout. When experiencing negative thoughts, ask yourself why you are feeling this way. By self-reflecting on these thoughts and identifying the root cause of them you are giving yourself an opportunity to change them into positive thoughts. Negative thoughts can be changed into positive thoughts through using positive self-talk and taking a moment of mindfulness. By changing negative thoughts into positive thoughts while exercising, you are able to turn around the exercise to benefit your overall health and mood.
Visualization strategies can also be helpful. Hone your thoughts and eyesight directly on the weights and visualize your success. Focus your breathing in tune with exerting force. See the success before it happens. While this may be a more advanced skill, it can be quite helpful.
If you are consistently struggling with positivity, gaining the support of a mental health therapist can be helpful. Cognitive Behavioral Therapy can help individuals shift their thoughts from negative to positive while focusing on developing coping mechanisms to decrease stress. A therapist can also help you get to the root cause of the negative thoughts, while providing support and guidance to heal. Cognitive Behavioral Therapy has benefits of increasing self-esteem and developing rational thought patterns to improve positivity. Shifting your thoughts and using positivity while exercising can improve fitness outcomes as well as mood and overall happiness.
becoming social again after covid
The impact COVID-19 had on socialization is immeasurable. As a society we experienced a lost sense of community due to being unable to effectively socialize. Health guidelines including social distancing and quarantining prevented the spread of COVID-19, yet took an emotional toll on many individuals. Being isolated from friends, family, and everyday routine is extremely difficult for humans. Socialization is a basic human need that helps ward off feelings of loneliness, sharpens cognitive skills, and increases one's sense of happiness and well-being. Although COVID-19 is still around, restrictions have lifted to effectively socialize with others and continue on with our daily routines. For some, this is an exciting time but for others this can prompt social anxiety and worry about health and safety. Improving one's comfort with socialization post COVID-19 is important to increase overall wellbeing.
One way to increase your comfort level with socialization post COVID-19 is to practice your social skills. This can be done through continuing daily conversations with those you feel comfortable with. Make an effort to practice your listening skills by asking open-ended questions and paying attention to what is said while being friendly. If you feel awkward during these conversations, know that this is a normal feeling experienced by many. Something to keep in mind is your social limits. These may have changed since before COVID-19. If at one point you were able to socialize for 4 hours and are now drained after an hour, reflect on this and try to find plans that fit your social limits. Avoid taking on too many social tasks all at once since your ability to manage social events has been reduced. Practicing self-care through journaling, exercising, or watching a relaxing television show is recommended to decrease stress after socialization.
Another way to increase your comfort level with socialization post COVID-19 is to address any safety concerns you may have surrounding social interactions. Although having these conversations can be awkward, it is important to have conversations to ensure everyone is on the same page. It is better to understand what will go on at the event than to arrive and be surprised that others are handling things differently than you. Keep in mind that it is acceptable to make suggestions or negotiate plans when you do not feel comfortable or safe. Doing so will allow others to know your concerns and provide support to minimize them.
If you are avoiding socialization and experiencing anxiety that is impacting your daily routine, it is time to seek the help of a mental health professional. With the help of a therapist, one can identify the root cause of the anxiety and develop coping strategies for when you are in difficult situations. Re-entering the world of socialization can create feelings of panic or anxiety. You are not alone.
Is Cbt for me?
Cognitive Behavioral Therapy, often known as CBT, is a form of psychotherapy that explores the connection between thoughts, feelings, and behaviors. It is used to treat a variety of mental health disorders and aims to decrease stress by helping individuals identify problematic thought patterns and subsequently develop positive thoughts, feelings, and behaviors. CBT helps individuals learn to change their perception, mood, and behaviors while viewing challenging situations in a new way. During the psychotherapy process, the counselor and client work together to create treatment goals and desired outcomes with a focus of gaining control of the client's thoughts.
How Can Cognitive Behavioral Therapy Help?
Cognitive Behavioral Therapy helps individuals learn to recognize their distorted thinking patterns that often create dysfunction in their daily lives. Once these thought patterns are identified, the counselor helps the client reevaluate the thoughts in light of reality while gaining an understanding of behaviors with the goal to develop problem-solving skills. Development of problem-solving skills and coping mechanisms are essential in the healing process as this will allow the client to deal with difficult situations while taking care of their emotional wellbeing. New habits can relieve mental health symptoms and allows the client to think and act in a more beneficial way.
Who Would Benefit from Cognitive Behavioral Therapy?
Everyone can benefit from Cognitive Behavioral Therapy, including individuals with a desire to identify, articulate, and change thoughts in the workplace. Even those that aren't experiencing a mental health disorder can find ways to improve their life with CBT. Some clients in sales will utilize it to help with sales techniques.
CBT involves techniques of getting frequent feedback, learning ways to calm the mind, and practices skills learned in therapy to promote positive behavioral change and growth. Through challenging underlying assumptions and distinguishing between facts and unhelpful thoughts, you can engage in Cognitive Behavioral Therapy to improve your mental health today.
Improving mental health through positive change.