Drugs Q & A

Does Spravato Get You “High”?

Euphoria, commonly known as a “high” is a feeling or state of intense excitement and happiness, it is an amplification of pleasure, a phase where one’s essential biological needs appear to be satisfied.

Euphoria is associated with many classes of addictive drugs and it is linked with the brain reward system. Drugs of abuse have in common the fact that they serve as biological rewards. They do so because of their ability to activate endogenous brain circuitry.

Drugs that cause euphoria activate the brain’s reward center by triggering the release of the brain chemical dopamine which surges, like waves producing high in the process. After repeated hits, the brain adjusts to this higher level of dopamine by making less of it and by reducing the number of receptors that can receive and transmit the signals it sends.

Having too much dopamine or too much dopamine concentrated in some parts of the brain and not enough in other parts is linked to being more competitive, aggressive, and having poor impulse control. It can lead to conditions that include ADHD, binge eating, addiction, and gambling.

What is Spravato?

Spravato is a brand of esketamine an antidepressant made from ketamine, an anesthetic that has also been used for many years to treat depression. But it wasn’t until recently that esketamine, a more potent version of ketamine, earned FDA approval specifically for use as a nasal spray for those with treatment-resistant depression on the 5th of March, 2019.

Spravato is derived from part of the ketamine molecule but it is more potent. As a result, it can be used at lower doses and theoretically have fewer side effects. Currently, Spravato is approved for people with treatment-resistant depression. That means you’ve tried at least two other antidepressants (for at least six weeks each) and haven’t experienced remission or at least a 50% improvement in mood.

For people who haven’t had success with other antidepressants, Spravato gives them hope that they can feel better with the right treatment.

Is Spravato a psychedelic?

Yes, esketamine the active ingredient in Spravato became the first FDA-approved psychedelic treatment for a psychiatric disorder in 2019.  In recent years, a slew of psychedelic agents have filled the drug development pipeline. These therapeutics are being investigated for treating conditions, such as major depressive disorder, severe anxiety, and substance abuse. Psychedelic therapeutics have moved from the fringes of medicine to the mainstream.

Does Spravato get you high?

Spravato (esketamine) produces psychedelic effects through glutamate receptor antagonism. Psychedelics (serotonergic hallucinogens) are powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes. They are generally considered physiologically safe and do not lead to dependence or addiction.

However, In a commentary in The American Journal of PsychiatryAlan F. Schatzberg, MD, of Stanford University School of Medicine in Stanford, California, argued that esketamine may carry a risk of abuse related to its “opioid properties” and questioned the efficacy of the new drug due to relatively small effect sizes.

Similarly, in The British Journal of Psychiatry, Mark A. Horowitz, MBBS, Ph.D., of the Division of Psychiatry, University College London, United Kingdom, criticized Janssen’s reliance on a single positive efficacy trial and a discontinuation trial.

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