b'NOW APPROVEDSPRAVATO, IN CONJUNCTION WITH AN ORAL ANTIDEPRESSANT, IS NOW APPROVED FOR THE TREATMENT OF DEPRESSIVE SYMPTOMS IN ADULTS WITH MDD WITH ACUTE SUICIDAL IDEATION OR BEHAVIOR (MDSI) 1Limitations of Use: The effectiveness of SPRAVATO in preventingsuicide or in reducing suicidal ideation or behavior has not been demonstrated. Use of SPRAVATO does not preclude the need for hospitalization if clinically warranted, even if patients experience improvement after aninitial dose of SPRAVATO. 1SPRAVATO is not approved as an anesthetic agent. The safety and effectiveness ofSPRAVATO as an anesthetic agent have notbeen established. 1Learn more at www.spravatohcp.comMDD=major depressive disorder.Important Safety InformationReference: 1. SPRAVATO [Prescribing Information]. Titusville, NJ: Janssen Pharmaceuticals, Inc. July 2020. WARNING: SEDATION, DISSOCIATION; ABUSE AND MISUSE; and SUICIDAL THOUGHTS AND BEHAVIORSIndications:See full prescribing information for complete boxed warningSPRAVATO (esketamine) CIII Nasal Spray is indicated, inRisk for sedation and dissociation after administration.conjunction with an oral antidepressant, for the treatment of: Monitor patients for at least two hours after Treatment-resistant depression (TRD) in adults. administration (5.1, 5.2).Depressive symptoms in adults with major depressive disorderPotential for abuse and misuse. Consider the risks and(MDD) with acute suicidal ideation or behavior. benefits of using SPRAVATO prior to use in patients atLimitations of Use:higher risk of abuse. Monitor for signs and symptoms ofabuse and misuse (5.3). The effectiveness of SPRAVATO in preventing suicide orSPRAVATO is only available through a restrictedin reducing suicidal ideation or behavior has not beenprogram called the SPRAVATO REMS (5.4).demonstrated. Use of SPRAVATO does not preclude the need for hospitalization if clinically warranted, even if patientsIncreased risk of suicidal thoughts and behaviorsexperience improvement after an initial dose of SPRAVATO. in pediatric and young adult patients taking SPRAVATO is not approved as an anesthetic agent. The safetyantidepressants. Closely monitor all antidepressant-and effectiveness of SPRAVATO as an anesthetic agent have nottreated patients for clinical worsening and emergencebeen established. of suicidal thoughts and behaviors. SPRAVATO is notapproved for use in pediatric patients (5.5).Please see additional Important Safety Information and Brief Summary of full Prescribing Information, including Boxed WARNINGS, on following pages.Janssen Pharmaceuticals, Inc. 2020November 2020cp-193335v1 1641587-CHAESK_Journal AD_Mech AP1_Rv8.indd 1 11/24/20 10:38 AM'