Family Psychological Services (FPS) is Offering Spravato® for Treatment Resistant Depression
We're pleased to offer our clients access to our new Spravato® clinic under the direction of Gilah Weissman, APRN and Jacob Taken, Office Manager. Please review the FAQ below to learn whether Spravato® might be right for you.
What is Spravato?
SPRAVATO® is a prescription medicine, used along with an antidepressant taken by mouth to treat adults with treatment-resistant depression (TRD). Click Here to Download the Patient Resource Brochure for Spravato® benefits, risks, and side-effects. You can click here to download the Spravato® digital treatment guide to answer additional questions about your course of treatment and experience with Spravato®.
FPS Spravato® Frequently Asked Questions
Do I have to be a client at Family Psychological Services in order to attend the Spravato® clinic?
At this time, everyone enrolled in our Spravato® clinic must be seen in psychotherapy at our office. As we expand capacity, we may extend the service to clients in ongoing psychotherapy with another therapist in the greater Douglas County area who agrees to engage in collaborative practice with our office using our secure email system. Each collaborative arrangement is subject to review and approval by our clinical staff. There is no cost to the provider or client for collaborative care.
What if I'm seeing another psychiatrist or APRN for my psychiatric medication?
To participate in our Spravato® clinic, you must transfer your psychiatric medication management to Gilah Weissman, APRN and be seen by her exclusively during the time you are enrolled in the clinic.
How do I know if Spravato® might be right for me?
If you’ve tried two or more antidepressants of adequate dose and duration during your current episode of depression and are still struggling with depressive symptoms, you can talk with Gilah to see if you may have treatment-resistant depression and if Spravato® might offer a pathway toward remission.
Will my insurance pay for Spravato® and what will my copay be?
Our office bills Blue Cross and Blue Shield, United Behavioral Health, and Aetna. We are currently reviewing our Cigna contract. We bill KanCare only for minors and minors are not eligible for Spravato®. Everyone who enrolls in the clinic is subject to Prior Authorization (PA). Prospective clients must enroll as a client in our patient portal, meet with Gilah Weissman, APRN to establish care and determine eligibility for a Spravato® PA. Clients already being seen for psychotherapy and/or medication management at FPS may consult with Gilah about Spravato® at any time. There is also a discount card for Spravato that will take your copay down to about $10 per administration. Care Coordination will work with you on that during the intake process. There will also be a copay for the treatment time at the clinic. That should be the same amount you pay Gilah for your regular med check appointments.
What about drinking alcohol or using other drugs? Will that impact my use of Spravato®
It might. You'll need to discuss this with Gilah and disclose all your substance use. What is very clear is that you must not drink or use any drugs, including canabis on the day prior to and after attending the clinic. If that level of abstience is going to pose a problem, we can't admit you to the program. If you are a moderate and occasional user and it does not occur during treatment days, this may not create problems for participation. However, failure to disclose is grounds for dismissal from the clinic and we may require UAs if any concerns about substanc use during treatment arise.
Are their other restrictions on the day of the clinic?
Yes. You need to abstain from eating or drinking anything (including water) for two hours prior to the clinic. Failure to do this can result in vomiting during the treatment. That won't impact the treatment itselt, but we presume you won't like it and we won't like cleaning it up. If you have a light lunch and stop drinking liquids after 2pm, you should be fine for our evening clinics. We suggest going easy on the food and (non-alcoholic) drinks after the clinic ends until you know how the treatment is going to affect you.
When is the Spravato® clinic?
Due to staff resource limiations and in order to match the clinic to the time of greatest demand, we will hold the clinic for two hours at 5:15pm on Monday and Thursday every week. We will add capacity to those times depending on level of demand.
How often must I attend the Spravato® clinic?
Spravato® takes a pretty significant commitment of time to be effective, particularly at the beginning of treatment. You must attend both clinics for two hours every week for approximately six weeks. In that time it should be very clear if the treatment is helping and the commitment is worth the time it takes. After six weeks Gilah will review your progress and you may be able to attend just one clinic a week. Eventually, in consultation with Gilah, you will be able to reduce to a less frequent attendance. At this time we do not believe that the population of treatment resistant clients is likely to be able to discontinue Spravato® but research is still ongoing on long term impact.
What if I miss a clinic?
While that's not the best course of treatment to benefit from Spravato®, you won't experience any ill effect if you have to bow out once or twice over the course of treatment. This might happen if you get sick (we definitely don't want you to come in that situation) or you are otherwise indisposed. We may find a way to do some make up times, but that will require coming during the day.
Will Gilah administer the Spravato®?
Actually, you will administer the dosage to yourself under the direction of office staff. Gilah will always be about six feet away in her office during the clinic. That's required under the Spravato® treatment protocol. She may be seeing other clients, but if any concerns arise, office staff will summon her away from those sessions to attend to those concerns. Office staff will check your vitals a few times over the two hour period and record the numbers. If they see any concerns, they'll bring Gilah in.
Is the Spravato® clinic subject to FMLA for my job or IDEA for school?
Because we must advise you that it's not safe to drive for the rest of the day, coming during the work or school day and then trying to go back to your normal routine is suboptimal. That's why we're only offering evening clinics at this time. But if you have to leave work early to attend the clinic, you should be eligible for FMLA if your place of employment is otherwise covered under this Federal law. We will work with clients for whom this poses a concern. If we do have sufficient demand to offer the clinic during the day and you need the full day off to attend, that too should be covered under FMLA and paid according to your PTO arrangement at work. If you need an accomodation for treatment as a student under IDEA, we believe that will be acceptable through the school's disability office if you are already filed with them. If you are not, you'll need to go through that procedure and we'll have to file a form requesting this as your accomodation.
What do I do while I'm at the Spravato® clinic?
Not much. Think of it as a time of relaxation and repose. You will self-administer the medication under supervision of the staff and then relax in a recliner in our quiet, spa like environment for two hours, being checked periodically for vitals. Gilah will be in an adjacent room and can check on you as needed. You will be under observation from office staff throughout your visit. You may nap, read a book, or look at your phone as long as you have ear buds so as not to distract others. You don't want to bring work from the office or a video game.
Are there other clients at the Spravato® clinic while I'm there?
Most likely. We're still studying how to utilize our space for this clinic. However, by enrolling you are agreeing to be seen in a passive group setting with between up to six other clients also receiving Spravato. You are not required to interact with the others in any way but, with their permission, you are free to do so. The only rule during this time is that you maintain respect for the calm environment and those receiving treatment in it.
What do I do after the Spravato® clinic?
You may not drive yourself home from the Spravato clinic. You will need to have someone come pick you up. If you would prefer to have your driver wait at the office, they may do so in our spacious waiting room. They can't sit in with you. We cannot release you from the clinic without a driver. You will likely feel fine after two hours at the clinic, but it is a requirement of the treatment protocol that you not operate a motor vehicle until the next morning after administration. Otherwise you should be able to carry on with your daily routine. We are still studying whether Uber or Lyft are safe alternatives for transportation and may do some discussion with certain drivers to assure safety. You can discuss this with Gilah and your therapist.
Can my very depressed under 18-year-old teen participate in the Spravato® clinic?
Not quite yet. While the FDA allows adult approved medications to be used with teens -- which is the vast majority of psychopharmeceuticals -- Spravato® is currently in trials for use with 16 to 18-year-olds. Until the FDA weighs in on those studies, insurance companies may not reimburse for the cost of treatment using Spravato®. Stay tuned to this page for additional details.
E-mail: fpsmedassist [at] fpssecure [dot] com