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St. Antonius Ziekenhuis

Nieuwegein, Netherlands

Treatment & access

About this provider

St. Antonius delivers esketamine nasal spray as a day-treatment programme at its Psychiatry & Psychology department: patients spend part of a day in hospital for each session. After referral by a GP or psychiatrist there is always an intake with a hospital psychiatrist, including safety checks and blood tests where needed; during the programme patients keep seeing their own clinician. Each session lasts 90 to 120 minutes with a professional caregiver present and blood pressure monitoring. The first four weeks run twice weekly; if the spray helps, sessions continue weekly for four weeks and then taper to every two to three weeks, with at least six months of treatment recommended.

Services & programs

  • Esketamine nasal spray as psychiatric day treatment (part of a day in hospital per session)
  • Intake assessment with a hospital psychiatrist, including safety evaluation and blood tests where needed
  • Supervised self-administration with a professional caregiver present and blood pressure monitoring
  • Effect and side-effect monitoring through questionnaires via the Mijn Antonius patient portal
  • Shared care: patients remain with their own GP or psychiatrist during the programme

Common questions

How is the referral organised?

Your GP or psychiatrist refers you to the hospital. You always first have an intake with a St. Antonius psychiatrist, who checks whether the treatment is safe for you. You can prepare by completing the digital questionnaires sent via Mijn Antonius, bringing your medication list, and asking someone to accompany you.

How do I prepare for a session, and can I drive home?

Do not eat for 2 hours before your appointment, do not drink for 30 minutes before, and use no other nasal spray for 1 hour before. You cannot drive yourself home afterwards: come by public transport or taxi, or have someone collect you.

What happens during a session?

You administer the esketamine yourself with a nasal spray pump, with a professional caregiver present the entire time and your blood pressure checked. A session takes 90 to 120 minutes. Side effects, if any, usually subside after about 40 minutes and have normally resolved within 90 minutes.

How often do I come, and what if it does not help?

Twice a week for the first 4 weeks, after which the hospital psychiatrist evaluates the effect with you. If it helps: weekly for 4 more weeks, then every 2 to 3 weeks or less, with at least 6 months of treatment recommended before tapering. If it does not help, treatment stops after 4 weeks and you return to your own clinician to discuss next steps.

Looking at alternatives? In the same region, UMC Utrecht and Altrecht (Utrecht) are also ENC-NL esketamine centres, and GGZ Centraal (Ermelo) publishes a patient folder for the same programme. See enc-nl.nl and our Netherlands country guide.

Verification

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