Understanding Spravato for Suicidal Ideation

Intrusive thoughts about dying can be deeply distressing, both for the person experiencing them and for their loved ones. The longer these thoughts continue, the higher the risk that the person might act on them. That’s why seeking effective treatment as soon as possible is so important.

In this article, we’ll discuss Spravato (esketamine) as an innovative FDA-approved treatment for suicidal ideation. We’ll explain Spravato’s benefits and risks, as well as what to expect from treatment at our New Jersey clinic. 

Rising Prevalence of Suicidal Ideation

What Is Suicidal Ideation?

Suicidal ideation refers to thoughts about ending one’s life, ranging from fleeting ideas to detailed planning. The American Psychiatric Association (APA) defines the condition as “Thoughts about or a preoccupation with killing oneself, often as a symptom of a major depressive episode.” 

As well as depression, suicidal ideation is a symptom of other mental health disorders, such as anxiety and post-traumatic stress disorder, though it can also appear on its own. The condition is likely when mental health issues are treatment-resistant, and it feels like there’s no hope of recovery. Suicide may feel like the only way to escape unbearable emotions and persistent negative thoughts. 

Rates of Suicide in the U.S.

While suicidal ideation doesn’t always lead to suicide, it’s a major risk. In 2023, the CDC reported that 12.8 million US citizens thought about suicide, and 1.5 million attempted suicide. Deaths were highest among non-Hispanic Native Indian and Alaskan citizens compared to other racial demographics, and among people aged 85 and over. 

With an estimated one death every minute due to suicide, there is an urgent need for effective treatments. 

Treating Suicidal Ideation

Crisis intervention is the first-line treatment for suicidal ideation. Several crisis hotlines are available for people to call if they feel at risk of taking their life. Medical services are also available, and include a combination of psychotherapy and antidepressant medications, such as SSRIs.

While helplines can be very helpful, they don’t always offer the level of support someone may need during suicidal thoughts. Psychotherapy can be more effective, but it often takes time to see progress, which can be frustrating and costly. Antidepressants may also take several weeks to work, and they don’t help everyone. 

Spravato as an Innovative Treatment for Suicidal Ideation

Spravato (esketamine) is an FDA-approved nasal spray derived from ketamine. It was approved in 2019 for individuals with treatment-resistant depression. The medication has notable rapid-acting benefits for alleviating suicidal thoughts, and was approved and one year later for adults with major depressive disorder with suicidal ideation (MDSI). 

Spravato has a unique mechanism of action compared to antidepressants, targeting different chemical pathways. Clinical studies have shown that Spravato can produce improvement in mood and suicidal thinking within hours to days, compared to the typical 4 to 6 weeks for conventional antidepressants.

Effectiveness of Spravato for Suicidal Ideation 

A 2021 study by Janssen Research & Development examined the outcomes of two clinical trials in which Spravato was administered to patients with MDSI. Over 450 patients in total were inclued and two-thirds had attempted suicide at least once in their lives.

For the majority of patients, suicidal thoughts decreased just four hours after treatment, and continued to decrease until the final measure at 25 days post-treatment. Symptoms of depression also significantly dropped.  

Another Phase 3 trial from Janssen Research, published in 2020, gave Spravato to elderly patients with depression, who are a high-risk demographic for suicide. Depression and suicidal ideation decreased, with results sustained up to four weeks.

Safety of Spravato for Suicidal Ideation

Spravato is considered to be a relatively safe treatment, with its side effects generally being mild and temporary. Side effects include things like:

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• Dissociation (feeling of separation from your body and environment)
• Increased heart rate and blood pressure
• Lightheadedness and feeling dizzy
• Sedation and sleepiness

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Because of Spravato’s cardiovascular risks, patients with certain heart diseases aren’t eligible to receive treatment. Patients also can’t operate machinery or drive for at least 24 hours after treatment because of its dissociative and sedative effects.

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What to Expect from Spravato Treatment at Reyou 

At Reyou Clinic, we are committed to helping our patients find hope and healing from suicidal thoughts. If you undergo treatment at our clinic, here’s what you can expect:

Comprehensive evaluation 

Your journey begins with a thorough assessment by our clinical team. We review your mental health history, current symptoms, and any medical conditions to ensure Spravato is a safe and suitable option for you. We also guide you through insurance coverage options, helping you understand what’s covered and assisting with any necessary paperwork.

Treatment process

Spravato is administered as a nasal spray in our clinic, under close supervision. You’ll self-administer the spray and then remain in the clinic under observation to ensure your safety. Our team will support you through the process and help manage any side effects. 

After you feel stable, you’ll meet with an integrator who can help you process any psychoactive effects experienced during treatment. Spravato can be psychedelic in nature, bringing about significant memories, strong emotions and new insights. 

A treatment schedule typically involves twice-weekly doses for the first four weeks, followed by more spaced-out maintenance doses thereafter.

Suicidal Ideation Support at Reyou

If you or someone you love is struggling with suicidal thoughts, please don’t wait. Help is available, and recovery is possible. There are many crisis helplines, such as 988 Lifeline, that are here to provide instantaneous support.

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At Reyou, our clinic is here to help you make long-lasting changes in your overall wellbeing, helping shift thoughts around suicide and death. We are leading providers of Spravato and intravenous (IV) ketamine therapy, which are clinically proven to help reduce suicide. Our team is here to support you on a journey to healing, providing additional  integration support to help you make the most of treatment.

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If you want to learn more about our services be sure to contact our clinic today. 

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