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Isala

Zwolle, Netherlands

Treatment & access

About this provider

Isala's psychiatry department in Zwolle runs an esketamine outpatient clinic for adults with difficult-to-treat (therapy-resistant) severe depression. Patients are referred by their own psychiatrist within the mental health system and must have tried at least two antidepressants without sufficient effect; esketamine is then used in addition to an antidepressant. The nasal spray is self-administered under supervision of a medical team, after checks such as blood pressure measurement; the strongest side effects have usually passed after about 1.5 hours. The treatment lasts half a year in total, starting with an induction phase of 4 to 8 weeks with two visits per week, followed by a maintenance phase of one visit per week and an optimisation phase up to six months. Isala participates in the national ENC-NL consortium coordinated by Radboudumc.

Services & programs

  • Esketamine nasal spray treatment (Spravato) for adults with difficult-to-treat depression at the esketamine outpatient clinic, psychiatry department
  • Participation in national ENC-NL research on longer-term outcomes of esketamine treatment

Common questions

How do I get referred?

Patients in the region are referred by their own psychiatrist within the mental health system. You must have tried at least two antidepressants before you can qualify; if esketamine is an option, it is given as an addition to an antidepressant.

What does a treatment visit look like?

You come to the department in the morning, where medical checks such as blood pressure measurement take place. After completing a questionnaire you lie down and administer the nasal spray yourself, under supervision of the medical team. Side effects such as high blood pressure, sleepiness and sometimes dissociation can occur; after about 1.5 hours the strongest effects have passed and you can go home.

How long does the treatment take?

Half a year in total. The induction phase lasts 4 to 8 weeks with two visits per week; if there is sufficient effect, a maintenance phase follows with one visit per week, and finally an optimisation phase until the six-month term is completed.

Is the treatment reimbursed?

Isala states the treatment is included in the depression guideline and is reimbursed; you can receive it if you have severe therapy-resistant depression and your insurer covers the costs.

Looking at alternatives? Esketamine nasal spray treatment is offered by specialised centres across the Netherlands affiliated with the national Esketamine Nasal Spray Consortium (ENC-NL), coordinated by Radboudumc.

Verification

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