Introduction

Spravato, also known as esketamine, is a nasal spray used to treat treatment-resistant depression (TRD) in adults. Approved by the U.S. Food and Drug Administration (FDA) in 2019, it has shown promising results for individuals who haven’t responded well to other antidepressant medications. While Spravato is highly effective for many, questions such as “Does Spravato cause weight gain?” have surfaced among patients and healthcare providers alike, particularly regarding its side effects.

In this article, we’ll explore whether Spravato causes weight gain, how it compares to other antidepressants, and other important factors related to weight management during treatment. Let’s dive deeper into what research and real-world experiences say about this commonly asked question.

What is Spravato (Esketamine)?

Spravato is a prescription nasal spray that contains esketamine, a derivative of ketamine, which is known for its fast-acting antidepressant effects. Unlike traditional oral antidepressants, which may take weeks or even months to show effects, Spravato can start to work within hours to days. It is usually administered in conjunction with an oral antidepressant under the supervision of a healthcare professional in a controlled clinical setting.

The mechanism of action of Spravato involves targeting the NMDA (N-methyl-D-aspartate) receptor in the brain, which plays a critical role in regulating mood and emotions. By modulating this receptor, Spravato helps restore the balance of neurotransmitters, alleviating depressive symptoms.

Common Side Effects of Spravato

Like any medication, Spravato has a range of side effects, but many patients wonder about the risk of weight gain. Common side effects of Spravato include:

• Dizziness
• Dissociation (feeling disconnected from reality)
• Nausea
• Fatigue
• Elevated blood pressure

These side effects are typically short-lived and occur shortly after administration. However, the concern over long-term side effects like weight gain requires further exploration.

Does Spravato Cause Weight Gain?

Weight gain is not listed as a common side effect of Spravato in clinical trials or official prescribing information. However, some individual experiences suggest that weight changes may occur during treatment. But does that mean Spravato directly causes weight gain?

Research Findings on Weight Gain and Spravato

There is limited research directly linking Spravato to significant weight gain. In fact, clinical trials conducted before FDA approval primarily focused on safety and efficacy rather than weight changes. Most of the documented side effects centered on cognitive, cardiovascular, and psychological effects, without any consistent reports of weight fluctuation.

That said, weight gain can be influenced by a variety of factors, including changes in lifestyle, diet, and mood, all of which could indirectly be affected by Spravato treatment. Depression itself is associated with changes in appetite and activity levels, so it is important to consider the overall mental health and lifestyle context when assessing weight concerns.

Comparing Spravato to Traditional Antidepressants

One key question for many patients is how Spravato compares to other antidepressants, particularly when it comes to weight gain.

Weight Gain and SSRIs/SNRIs

Commonly prescribed antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), have been more frequently associated with weight gain. For example, medications like citalopram, fluoxetine, and venlafaxine are well-documented for potentially causing weight gain in long-term users.

In comparison, Spravato does not appear to share the same risk. Many antidepressants impact serotonin, which influences appetite and metabolism. Since Spravato acts through a different mechanism (the NMDA receptor), the same appetite-modifying effects are less likely to occur.

Factors That Could Contribute to Weight Gain

Even though Spravato itself is not directly associated with weight gain, there are several factors to consider:

1. Changes in Appetite and Energy Levels

Depression can influence both appetite and energy levels, sometimes leading to weight gain or weight loss. As patients begin to feel better with Spravato, they may experience changes in eating habits and physical activity. For some, this could lead to increased food intake or a reduced motivation to stay active, which might result in weight gain.

2. Concurrent Medications

Many people taking Spravato are also prescribed other antidepressants. If these medications are known to cause weight gain, such as SSRIs or mood stabilizers like lithium, the combination could contribute to overall weight changes. It’s important to evaluate the full medication profile when considering side effects.

3. Diet and Exercise Habits

Personal habits surrounding diet and exercise play a significant role in weight management during any treatment. For individuals undergoing treatment for depression, maintaining a healthy routine can be difficult but is crucial in avoiding unwanted weight gain.

How to Manage Weight During Spravato Treatment

For individuals concerned about potential weight gain during Spravato treatment, here are some practical strategies:

1. Monitor Eating Habits

Tracking daily food intake can help identify any patterns or overeating tendencies that could lead to weight gain. Apps or journals that log caloric intake and nutritional quality can be helpful tools for this.

2. Stay Physically Active

Exercise is not only beneficial for mental health but also for weight management. Incorporating daily physical activity, such as walking, jogging, or even yoga, can improve mood and help regulate body weight.

3. Speak to Your Healthcare Provider

If you’re noticing unexpected weight changes while on Spravato, talk to your healthcare provider. They can help assess whether the weight gain is related to the treatment or other factors, and they may suggest adjustments to your treatment plan if necessary.

4. Consider Behavioral Therapy

Behavioral interventions, like Cognitive Behavioral Therapy (CBT), may help address issues like emotional eating or inactivity, which can contribute to weight gain. Combining therapy with medication like Spravato often yields better overall results in managing depression and its side effects.

Spravato and Long-Term Use

Spravato is typically used in conjunction with an oral antidepressant for a limited period, especially during acute depressive episodes. Long-term studies on the use of Spravato are still ongoing, so it’s important to stay informed about new research on side effects and efficacy. As more data emerges, we’ll have a clearer picture of how Spravato affects weight and other long-term health outcomes.

Conclusion

Spravato is an innovative treatment for treatment-resistant depression, offering hope to individuals who have not responded to traditional medications. While weight gain is a well-known side effect of many antidepressants, current research suggests that Spravato is less likely to cause this issue. However, factors such as lifestyle, concurrent medications, and changes in appetite may influence weight during treatment.

If you’re considering Spravato or are already on it, maintaining healthy habits, staying physically active, and closely monitoring your weight can help mitigate any potential weight changes. Always consult with your healthcare provider about any concerns or side effects during treatment to ensure you’re on the right path to mental and physical wellness.