Marvelous May – What is Esketamine/Spravato & Other News…


How is it already May? Time appears to be moving faster than usual lately. You may have noticed that we skipped our March and April newsletter; my apologies. It is my intention to publish this monthly to keep our ketamine community informed on the progress made in this field of medicine. As many of you have noticed, there has been a lot of buzz about ketamine in the last few months. I shall take this moment to get you all caught up.

In March, the FDA approved a new medication to administer to those who suffer from treatment-resistant depression. Spravato (Esketamine) was approved, and my team and I were shocked at how quickly the news spread. Our phone rang constantly for weeks with prospective patients eager to learn all about this new medicine, and existing patients who had questions on whether or not Spravato was a viable treatment option for them. There is much to understand about this new addition to the ketamine family. I’m very pleased that the FDA has approved this advancement in the treatment of depression.

Here is my take on the basics of Spravato:

  • Spravato is big pharma introducing an old drug in a new way so that they can obtain a patent. Rather than approve ketamine for depression and other mood disorders, they have created something “new” to give patients.
  • Ketamine, which has been around for over 50 years, consists of two molecules, an “R and S.” Johnson and Johnson (Janssen) patented the “S” molecule as a stand alone medication and named it Spravato. So technically Spravato consists of one isomer of the two which make up racemic ketamine.
  • To qualify for Spravato nasal spray, patients must currently be taking an antidepressant and be diagnosed as treatment resistant.
  • Patients require a two-hour office visit where the doctor supervises the patient’s administration of the nasal spray and monitors the patient. The minimum commitment for this treatment is two visits per week for 4 weeks, then once a week for 5-8 weeks, then every two weeks at 9 weeks until… there is no clear end date for this treatment.
  • The long-term benefit is still unknown, Spravato is a treatment not a cure.
  • The nasal spray has a limited bio-availability, with the route of administration being through the nose, the amount of medicine received will vary, it averages around 40%, which is also its “success rate.”
  • All patients are limited to a fixed dose of either 56mg or 84mg.
  • There is no long-term research on its success rate, Spravato’s research group was followed for one year only. No independent research was done.
  • Short term side-effects are similar to that of ketamine: dissociation, dizziness, nausea, sedation, vomiting, etc.
  • Long term side effects unknown.

This highlights some key items to note about the new drug, Spravato. Although we are an approved Spravato provider, we are not yet offering this treatment. In my opinion, IV Ketamine Infusion Therapy remains the gold standard. With decades worth of research, (my clinic alone having treated over 1,000 patients in the last five years), I know for a vast majority of patients, IV Ketamine Infusion Therapy works. Ketamine Therapy offers:

  • 100% bio-availability of the medication
  • Over an 80% success rate of relieving symptoms in patients
  • Less clinical visits needed to see results
  • Overall less expensive
  • Decades worth of non-biased research proves the benefit
  • No known long-term side effects
  • Long lasting relief in-between treatments (average of 3-4 months)
  • No requirement to be on an antidepressant in order to receive treatment
  • Dosing and treatment is personalized, larger doses may be administered

At Ketamine Clinics of Los Angeles, we believe ketamine is the best medicine for the treatment of depression and suicidality. We encourage you to do your research and educate yourself on your options. We are enthusiastic and pleased that the FDA has approved esketamine for the treatment of depression and mood disorders; it is a huge step forward in behavioral medicine.

Outside of this exciting news, in clinic we have all been busy at work, enjoying our new space and building our team so that we can continue to provide you with the excellent care that you have come to expect from the team at Ketamine Clinics of Los Angeles! We hope you are well, and we wish you a Marvelous May!
Dr. Mandel



Bustle Magazine
Esketamine Is A New Medication For Treatment-Resistant Depression, But It’s Not For Everyone
Read more

Discover Magazine
From Popular Anesthetic to Antidepressant, Ketamine Isn’t the Drug You Think It Is
Read more

Filter Magazine
Rethinking Ketamine in Light of a Newly Approved Depression Treatment

The Verge
The FDA approved a new ketamine depression drug – here’s what’s next
Read more


May 12th is International Nurses Day! We have some wonderful nurses at our clinic that make us extremely proud to celebrate this month. In celebration, we had sushi delivered for a team lunch. Find below our nurses: Nicki, Denisse & Stephanie.


unnamed-1Stay-at-Home-Mom Depression Is Real and Women Are Finally Talking About
May is the month we celebrate and honor mothers for all the unconditional love they provide. Although many moms boast parenthood as their greatest joy, some moms really struggle. According to this article, 25% of mothers are stay at home moms (SAHM) and it is not as easy as one may think. Thank you Glamour for shedding light on the realities of this circumstance. Read more

unnamed-2Exercise May Help to Fend Off Depression

Jogging for 15 minutes a day, or walking or gardening for somewhat longer, could help protect people against developing depression. Read more



We always have reasons to celebrate and fortunately our new office location has a Dave and Busters nearby. What a treat to get “almost” all of our team together for food, fun, and team bonding. The 6-minute virtual reality ride totally impressed us all. It was truly out of this world!

This particular team night was memorable and a little emotional. We officially said farewell to our nurse Mary, and hello to Conor (Physician’s Assistant), Nicki (Registered Nurse) and Jada (Administrative Assistant). (Keep an eye out for next month’s newsletter where we will share more on these fabulous new members!) So many feels for us all. We continue to be grateful to have a team with so much heart!

Mary, we thank you for your service. It’s been a wonderful 2+ years. You are a fantastic nurse and a great person. May this next chapter in your life bring you everything you could ask for! We miss you already!

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