SPRAVATO® Intranasal Esketamine & Intramuscular Ketamine Treatment Center
We offer SPRAVATO® intranasal esketamine and intramuscular ketamine treatment therapy to patients in western North Carolina.
Our mission is to help treat major depression, PTSD, and related anxiety conditions through newly approved medications and methods in psychiatry.
Certified treatment facility and affiliate of the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program. We offer intranasal esketamine administration in accordance with REMS guidelines.
Intramuscular ketamine injections for fast-acting relief. Ketamine itself is also fast-acting, and many patients notice results within 24 hours. Intramuscular injections allow your body to absorb the medication right away.
Our team provides expert consultation and evaluation of individual patient needs. All patients must provide a referral from a primary care provider or outpatient psychiatrist before proceeding with consultation and treatment.
ANTHONY A. FRASCA, MD, MSPH
Board Certified in Psychiatry
Since 1997 it has been my passion and privilege to help people struggling with the most severe behavioral health conditions. During these 23 years of practice I've seen the abilities, and sadly, the limitations of current psychiatric practice. But a new era of treatment is dawning, with opportunities to marry expertly applied standard care to newly approved medications and modalities that will help those for whom typical current care has not been enough.
Over several decades, research has shown that ketamine has antidepressive properties. Ketamine is approved by the U.S. Food and Drug Administration (FDA) for the induction and maintenance of anesthesia, although it is also being used for the management of psychiatric disorders and chronic pain management. Ketamine has been incorporated into the treatment of psychiatric disorders, such as major depressive disorder (MDD), bipolar disorder, and post-traumatic stress disorder (PTSD), as well as post-operative and chronic pain management. Ketamine therapy is not a first-line therapy for psychiatric disorders or chronic pain management and may be considered by the patient’s interdisciplinary team after failure of standard treatment. Please note that esketamine nasal spray, a derivative of ketamine, has been separately approved by the FDA for treatment-resistant depression.
Ketamine can be administered in several different ways: by an intravenous infusion, an intramuscular injection, intranasally, sublingually, and orally. These different routes of administration come with a higher or lower bioavailability; in practice intravenous and intramuscular administration allows the most ketamine to affect the body, while the other routes result in lower effective doses due to metabolism and other factors. Intravenous ketamine infusions, typically over 40 minutes, have been most studied because of their historical use and the original FDA approval of ketamine for anesthesia in the 1960s. Pharmacokinetic data suggest an intramuscular injection results in active drug levels very similar to a forty minute long infusion, and empirically studies have shown equivalent efficacy (or benefit) with intramuscular administration. It is unlikely that intravenous ketamine infusions are more effective than other routes of administration, but this certainly results in greater patient discomfort, greater resource utilization, and ultimately higher cost.
SPRAVATO® is a prescription medicine, used along with an antidepressant taken by mouth to treat:
- Adults with treatment-resistant depression (TRD)
- Depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions
SPRAVATO® is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO® is safe or effective as an anesthetic medicine.
Patients seeking ketamine treatment for treatment-resistant depression (TRD) should consult with their primary care provider. We accept patient referrals from qualifying providers. Patients must undergo pre-treatment medical consultation prior to starting treatment. We offer expert evaluation of individual patient needs through our own direct consultation and psychiatric post-treatment evaluation.
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Alcohol, excessive use
- Brain or nerve disease
- Drug abuse or dependence, history of
- Heart disease
- Liver disease
- Lung or breathing problems—use with caution. May make these conditions worse.
- Hypertension (high blood pressure), severe—should not be used in patients with this condition.
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of ketamine injection in children younger than 16 years of age. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ketamine injection in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving ketamine injection.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
The first and only NMDA receptor antagonist approved for 2 subtypes of MDD in adult patients:
Studied in more than 1700 adult patients with treatment-resistant depression across all studies, SPRAVATO® was approved by the FDA in March, 2019.
- FDA Approved
- Safe & Effective
- Available only through the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS)
- Long term efficacy demonstrated
- Comfortably administered
- Only dispensed and administered in healthcare settings
A New Dawn In Psychiatric Treatment
We offer expert psychiatric care using innovative treatment practices in a peaceful environment. Our medical staff will help to ensure your experience is positive and safe.
why choose us
Offering the latest advancements in treatment for mental health and depression, our facility is innovative and unique.
Our team is passionately dedicated to helping you overcome your disorder. Through expert consultation and guided sessions, our prescriptive treatments are tailored to each individual patient’s needs. We’re here to help.