Misleading claims arise about Spravato, an antidepressant nasal spray

Recent discussions also stigmatized bipolar disorder and used mental health terms to joke about Elon Musk’s arm gesture at the presidential inauguration.

This past week, posts discussed Spravato, a nasal spray that was recently approved as a standalone treatment for depression, with some warning against taking it due to potential side effects. Plus, other posts mocked a person who allegedly lost their antipsychotic medication at a protest, with some expressing stigmatizing attitudes toward people with bipolar disorder. Additional posts discussed anxiety and Elon Musk’s controversial arm gesture at President Donald Trump’s inauguration.

In light of these conversations, communicators may share information about Spravato and other treatment options for depression, circulate materials about bipolar disorder and anxiety, and offer tips for reducing stigma toward people with mental health conditions.

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What’s trending nationally in conversations about mental health

On January 21, the U.S. Food and Drug Administration expanded its approval of Spravato, an antidepressant nasal spray derived from ketamine. When the medication was first approved in 2019, patients were required to take an oral antidepressant medication in addition to Spravato. Now, Spravato is approved as a standalone treatment for depression for people who have tried at least two oral antidepressants and have not seen adequate results. It must be administered under the supervision of a health care provider. Social media users discussed Spravato across multiple platforms, with some posts receiving millions of views. Some commenters warned about potential side effects, while others celebrated the “breakthrough” treatment, stating, “It saved my life.”

On January 22, an X post shared photos of alleged vandalism that occurred during a Portland, Oregon, protest against the Trump administration, receiving approximately 2.7 million views, 57,000 likes, 8,200 reposts, and 2,700 comments as of January 29. The post claimed that protesters left behind “Bipolar Meds” and other items and shared a photo of a prescription bottle containing quetiapine—an antipsychotic medication that is approved to treat bipolar disorder, schizophrenia, and other mental health conditions—in the comments. Several comments mocked the protester who allegedly lost their medication and expressed stigmatizing views toward people with bipolar disorder.

On January 20, the Anti-Defamation League shared an X post stating, “Our politics are inflamed, and social media only adds to the anxiety.” The post went on to reference Elon Musk’s arm gesture during President Trump’s inauguration, which many interpreted as a Nazi salute. The post called Musk’s arm motion “an awkward gesture in a moment of enthusiasm, not a Nazi salute,” and stated that “all sides should give one another a bit of grace, perhaps even the benefit of the doubt.” The post received approximately 43.8 million views, 35,000 likes, 20,000 reposts, and 20 comments as of January 29 (only accounts that the Anti-Defamation League follows or mentioned in the post were able to reply). Another X post joked, “What if he did a heil hitler because he has anxiety,” receiving approximately 1.6 million views, 73,000 likes, 3,200 reposts, and 220 comments as of January 29. Some comments repeated the joke that Musk made the gesture due to anxiety, and a few joked that autism caused his arm motion.

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about mental health.

Trending conversations about Spravato—a brand name for esketamine nasal spray—provide an opportunity to explain how this medication works, along with other treatment options for depression. Messaging may explain that depression is typically treated with therapy and oral medications. Spravato is approved for people whose depression symptoms have not responded to at least two oral antidepressants. Messaging may explain that unlike other medications that treat depression, which typically increase naturally occurring brain chemicals like serotonin, norepinephrine, and dopamine, Spravato increases levels of glutamate, the brain’s most abundant chemical messenger. The FDA’s expanded approval of Spravato is based on extensive clinical trials demonstrating its safety and effectiveness. While most antidepressants take weeks to take effect, Spravato can provide immediate relief from depression symptoms. However, Spravato can only be administered under the guidance of a health care provider, as it may cause side effects such as drowsiness, loss of consciousness, confusion, and high blood pressure. Spravato may not be right for people with certain health conditions, so patients should talk to their health care provider about their medical history before pursuing treatment.In light of concerns about antidepressants, communicators may explain that these medications have been shown to reduce symptoms of depression and some other mental health conditions and are most effective in people experiencing moderate or severe depression. The FDA approves antidepressants for use in children and teens, depending on age. Some antidepressants carry an FDA warning about a risk of increased suicidal thinking and behavior in some people under the age of 25. This warning was issued in 2004 after an FDA analysis of clinical trials showed that some children and teens taking antidepressants experienced a slight increase in suicidal thoughts. However, none of the children or teens in these studies died by suicide. Some mental health experts believe that this warning is unnecessary, as newer research suggests that the benefits of antidepressants may outweigh potential risks in young people. Plus, untreated depression remains a major risk factor for suicide. Messaging may emphasize that anyone taking antidepressants should do so under the guidance of a health care provider and that antidepressants may work best in combination with therapy. Including the 988 Suicide & Crisis Lifeline in any messaging about suicide is recommended.

Discussions about bipolar disorder and anxiety demonstrate ongoing stigma around these mental health conditions. Educational content can highlight the symptoms of these conditions, plus treatment options. Sharing general mental health resources, such as therapist directories, support groups, local mental health centers, and the 988 Suicide & Crisis Lifeline, is recommended. Communicators may also want to share information about fighting mental health stigma and tips for coping with stigma.