Spravato is the brand name of esketamine, a nasally adminitsered medicine used for the rapid treatment of moderate to severe depression. Spravato was initially released by Johnson & Johnson in the US at the beginning March 2019. In the UK, it is now a medcine (by Janssen-Cilag) and available from specialist psychiatric prescribers and pharmacies around the UK.
Current NHS availability in the UK
In late 2019 Spravato was licensed for use in the UK. The current license holder is Janssen-Cilag and the medicine is listed in the British National Formulary as:
“Available in the UK. Price 1 x 28mg nasal spray = £163“
To access esketamine for depression, a prescription written by a psychiatrist is needed. Psychiatrists in the UK work either within the NHS (where you can potentially source the prescription + medicine for free) or from the Private sector (at a cost). Even though the National Institute of Clinical Excellence (NICE)4 has shown esketamine has positive effects it has limited availability on the NHS as it is not generally considered cost effective. The only publicised NHS availability of esketamine is in Scotland where the Scottish Medicines Consortium (SMC) accepted the use of esketamine (Spravato; Janssen) nasal spray for use within NHS Scotland for adults with treatment-resistant major depressive disorder on 8th September 2020.
This does not mean it is not available eslewhere in the UK, only it is unlikely you can access the medicine through an NHS GP, you will need to consult outside of the NHS i.e. via a private prescriber.
Current Private sector availability in the UK
The main source of esketamine for depression in the UK is via private medical clinics5. The license of esketamine in the UK requires patients to meet the following three conditions:
- taking either an SSRI or an SNRI.
- diagnosed by a licensed doctor as suffering from “treatment-resistant Major Depressive Disorder”.
- unresponsive to at least two different treatments with antidepressants in the current moderate-to-severe depressive episode.
If you meet the above crietria and are interested in obtaining treatment we have found the following clinics as possible sources of the treatment.
- Leeds – 07547759264: email@example.com
- Northamptonshire Healthcare – 01604 685590/91: firstname.lastname@example.org
- Warrrington – experttms.co.uk/esketamine-clinic/- 01925 691502: email@example.com
- London – Saveminds.co.uk – +442077220865: firstname.lastname@example.org
- Oxford – Littlemore Mental Health centre: email@example.com: 01865901000
In the event that you need further help in sourcing the medicine of finding if you are eligible, contact our Psychopharmacologist specialist via this link.
How esketamine is administered
Spravato is intended to be self-administered by the patient under the direct supervision of a healthcare professional. A treatment session consists of nasal administration of Spravato and a post-administration observation period. Both administration and post-administration observation of Spravato should be carried out in an appropriate clinical setting.
Alternatives to esketamine
There are some clinicians administering the drug in its original ketamine form as ‘off-label’ treatment, below is a list of what is available in the UK:
- Oxford health – NHS foundation Trust – initial consultations cost £150.
We will be continually updating this blog (last updated 30th July 2020) to chart esketamine’s progress so if you are interested and would like alerts please consider following us on social media or subscribe to this blog for further updates.
Frequently Asked Questions about Esketamine
Our prescribing team at Voyager Medical has received a wide range of questions regarding esketamine availability in the UK. We have now created a dedicated page called Frequently Asked Questions about Esketamine, click the link for more information.
- Ketamine enantiomers in the rapid and sustained antidepressant effects. Published: 2016 Jun. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910398/
- Ketamine-related drug could be ‘watershed’ in treating depression, 2019,https://www.theguardian.com/society/2019/mar/08/new-ketamine-related-drug-could-be-watershed-in-treating-depression.
- A Long-term Safety Study of Intranasal Esketamine in Treatment-resistant Depression, 2016: https://clinicaltrials.gov/ct2/show/NCT02782104
- Esketamine for treatment-resistant depression (ID1414). https://www.nice.org.uk/guidance/proposed/gid-ta10371
- Ketamine-like drug for depression could get UK licence within the year, published 14th July 2019. https://www.theguardian.com/science/2019/jul/12/ketamine-like-drug-for-depression-could-get-uk-licence-within-the-year