Spravato® (Esketamine)

FDA-Approved Relief for Treatment-Resistant Depression

Spravato® is a groundbreaking, FDA-approved treatment for adults living with treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal thoughts or behaviors. Unlike traditional antidepressants that can take weeks to work, Spravato® can provide relief within hours to days for many patients.

It is delivered as a nasal spray in a medically supervised setting and works differently from typical antidepressants, targeting the NMDA receptors in the brain and enhancing neuroplasticity—the brain’s ability to heal, rewire, and grow.

Who is Spravato® For?

Spravato® is approved for patients who:

• Have treatment-resistant depression (TRD)—meaning they’ve tried at least two different antidepressants (SSRIs, SNRIs, NDRIs, TCAs, or MAOIs) without sufficient improvement.
• Have major depressive disorder with suicidal ideation or behavior.
• Are under the care of a healthcare provider and have ongoing support for depression treatment.

Insurance Coverage:

Most insurance companies cover Spravato® once you meet criteria for treatment resistance. We work closely with your insurance to handle prior authorizations and ensure coverage approval.

Who Should NOT Use Spravato®?

Spravato® is not recommended for patients with:

• Aneurysmal vascular disease, including in the brain, chest, or abdomen
• History of intracerebral hemorrhage (bleeding in the brain)
• Uncontrolled high blood pressure
• Allergy to esketamine or ketamine
• Pregnant

Your provider will assess your full medical history to ensure Spravato® is safe and appropriate for you.

How Spravato® Works

• Spravato® is a nasal spray that contains esketamine, a more potent mirror-image form of ketamine.
• It targets glutamate, a neurotransmitter that plays a role in mood regulation, rather than serotonin or norepinephrine.
• It enhances brain connectivity and neural regeneration, helping to lift mood and relieve depressive symptoms even when other medications haven’t worked.

Spravato® is especially effective for patients struggling with suicidal thoughts, offering a fast-acting option while waiting for other medications or therapies to take effect.

What to Expect During a Spravato® Session

Each Spravato® treatment is a 2-hour in-office session under medical supervision:

1. Arrival & Check-in: We’ll take your vitals and review your mental and physical health.
2. Self-Administration: You’ll administer the nasal spray yourself, with a provider guiding you.
3. Observation Period: For the next 2 hours, you’ll remain in a comfortable setting while we monitor your blood pressure, heart rate, and overall response.
4. Discharge: You will need a ride home, as driving is not permitted until the next day.

Treatment Schedule

Spravato® is administered in phases:

• Weeks 1–4 (Induction Phase): 2 treatments per week
• Weeks 5–8 (Optimization Phase): 1 treatment per week
• Week 9 and beyond (Maintenance Phase): Treatments are typically reduced to every 1–2 weeks, depending on your response

Each treatment is customized based on your individual needs and clinical progress.

How Quickly Does It Work?

Many patients report a noticeable improvement in mood after just a few sessions. For those with suicidal ideation, Spravato® may significantly reduce the intensity and frequency of these thoughts within hours to days.

Common and Rare Side Effects

Temporary and Common Side Effects (during or shortly after treatment):

• Dissociation (feeling detached from body or reality)
• Dizziness or lightheadedness
• Nausea
• Increased blood pressure
• Sleepiness or fatigue

These effects are transient and typically resolve within 1–2 hours after treatment.

Rare but Serious Side Effects:

• Increased blood pressure requiring intervention
• Sedation requiring extended monitoring
• Drug abuse or dependence potential (rare with medical supervision)
• Bladder or urinary symptoms (extremely rare)

All treatments are conducted in a REMS-certified clinic with trained medical staff to ensure your safety.

Why Choose Spravato®?

• Fast-acting relief for depression and suicidal thoughts
• Covered by insurance once criteria are met
• Offered in a safe, structured, and calming medical environment
• Helps people who have not responded to typical antidepressants

How to Get Started with Spravato® Treatment

We’ve made the process simple and supportive from the start. Follow these easy steps to begin your journey with Spravato®:

Step 1: Complete the Contraindication Questionnaire

-Start by filling out the brief questionnaire and your contact information at the bottom of this page. This helps us determine if Spravato is safe and appropriate for you.

-Our office will contact you to let you know if you are a good candidate. If you are a good candidate, we will invite you to schedule your free consultation.

Step 2: Schedule Your Free 30-Minute Consultation

-This no-cost consult allows us to learn more about you and your goals, and to make sure Spravato® is a good fit.

-We will also confirm to make sure you do not have any contraindications for Spravato®.

-If everything looks good, we’ll invite you to book a medical clearance appointment with one of our providers at the end of the consult.

Step 3: Complete Your Medical Clearance Appointment

-This is a full evaluation with one of our licensed medical providers for them to get to know you.

-We’ll go over your medical and psychiatric history, discuss various options, how Spravato® works, review potential benefits and side effects, and answer any questions you may have.

-If you’re medically cleared, we will contact your insurance company to get you approved for Spravato® treatment. Once you are approved, we will contact you to schedule your preparation session.

Step 4: Attend Your Preparation Session

-This session helps you feel mentally, emotionally, and spiritually ready for treatment.

-You’ll have space to ask questions, understand what to expect, and set an intention for your upcoming Spravato® sessions.

-Our goal is to help you feel fully supported and empowered before your first treatment.

Ready to Begin?

Click below to complete the Contraindication Questionnaire and take the first step toward healing.