Posted by Couleuvre on July 1, 2019, at 4:14:23
In reply to Re: Spravato (esketamine) » Couleuvre, posted by Ruuudy on June 15, 2019, at 17:36:03
(Sorry I took so long to post. I've had an awful cold. I've been exhausted all the time, with lots of coughing and the like. Bleah. FWIW, aspirin or ibuprofen or another NSAID is pretty good for the sore throat you get with too much coughing. Helps keep it from turning into bronchitis (a "Boston cold").)
My doctor is very forward-thinking, yes. I think if you've got TRD and have tried all the ordinary stuff, you need someone like that if you're to have any hope of getting better. I'm seeing him at an outpatient clinic at an academic medical centre; the way it works is the attending physicians supervise a certain number of residents (the young docs who just finished med school; residency is a different number of years in different specialties, I think for psychiatry it's 3). The residents mostly just make decisions on their own, although I'm pretty sure they're supposed to at least check with the attending before making a change. But the attending actually sits in on my appointments for the last 10-15 minutes or so and makes suggestions and stuff. My impression is that he does this because: (1) he knows that the residents would be helpless to do anything for me, and (2) he considers me more "interesting" because of my lengthy and elaborate history and unusual list of meds. He's pretty cool, and if he doesn't sincerely care about me, he does a really good job of faking it. <g>
I've had a lot of lousy docs who are totally closed-minded about trying anything remotely different from the standard stuff, and since I don't live in a big city or anything, I feel *really* lucky to have found someone who really knows what he's doing and all that.
So how is the Spravato administered - how is it dosed (what's the concentration? it should say on the bottle), and how often do you take it?
The big trouble with IN administration is that the absorption is kind of unpredictable compared to other routes. I'm sorta wondering why they decided to go with it, because I think esketamine could be administered by several routes that would be more convenient for the patient than having to go to a clinic to get IV injections and more consistently absorbed than IN, so that you could generally expect that if dose X works well for a certain patient while minimising side effects, then you can have that patient keep taking dose X and assume that it will keep working and there won't be any big changes in side effects.
So...anybody have any idea how expensive Spravato is?
poster:Couleuvre
thread:1104865
URL: http://www.dr-bob.org/babble/20190513/msgs/1105080.html