Yes, Spravato (esketamine) can potentially trigger mania or hypomania in people with bipolar disorder, although this appears to be uncommon. The risk is generally higher in individuals with bipolar I disorder, a history of manic episodes, or those receiving treatment without a mood stabilizer. Because of this possibility, Spravato should only be used after a thorough psychiatric evaluation and with close monitoring by a qualified mental health provider.
Why can Spravato trigger mania?
Spravato works differently from traditional antidepressants by targeting the brain’s NMDA receptors, which influence glutamate signaling. While this mechanism can rapidly improve symptoms of treatment-resistant depression, it may also increase brain activity in ways that contribute to a manic or hypomanic episode in susceptible individuals.
Read More: Is Spravato Approved for Bipolar Depression?
Who is at higher risk?
The likelihood of mania may be greater if you:
- Have a diagnosis of bipolar I disorder.
- Have experienced previous manic or hypomanic episodes.
- Have a family history of bipolar disorder.
- Are taking Spravato without a mood stabilizer or other appropriate bipolar treatment.
- Have previously developed mania after starting an antidepressant.
What symptoms should you watch for?
Contact your healthcare provider promptly if you notice symptoms such as:
- Unusually elevated or euphoric mood.
- Increased energy with little need for sleep.
- Racing thoughts or rapid speech.
- Impulsive or risky behavior.
- Increased irritability or agitation.
- Inflated self-confidence or grandiosity.
Recognizing these symptoms early can help prevent a full manic episode and allow your treatment plan to be adjusted quickly.
Can people with bipolar disorder still receive Spravato?
In some cases, yes. A psychiatrist may recommend Spravato for certain patients with bipolar depression when the potential benefits outweigh the risks. Treatment decisions are individualized and often include careful screening, ongoing monitoring, and the use of mood-stabilizing medications when appropriate. Spravato should never be started or stopped without medical supervision.
Read More: Can Spravato Help Bipolar Depression?
The bottom line
Spravato can trigger mania or hypomania in some people with bipolar disorder, but the risk varies from person to person. A comprehensive evaluation, an accurate diagnosis, and close follow-up with a mental health professional are essential to determine whether Spravato is a safe and appropriate treatment option.
Looking for Spravato Treatment in Dallas?
If you’re exploring Spravato treatment in Dallas for treatment-resistant depression or have questions about whether it’s appropriate for bipolar depression, the experienced team at Insight Mental Wellness can help. We provide comprehensive psychiatric evaluations, personalized treatment plans, and ongoing monitoring to ensure Spravato therapy is delivered safely and effectively.
Schedule a consultation with Insight Mental Wellness today to discuss your symptoms, review your treatment options, and determine whether Spravato therapy is the right choice for your mental health needs.