Spravato® (Esketamine) Therapy

 If traditional oral antidepressants haven't provided the relief you need, you are not out of options. At our clinic, we provide FDA-approved Spravato® (esketamine) nasal spray administered in a certified, medically supervised setting. 

Spravato is an FDA-approved prescription nasal spray for adults living with:

• Treatment-Resistant Depression (TRD): Depression that has not responded adequately to at least two different antidepressant treatments.
• Major Depressive Disorder (MDD) with Suicidal Ideation: For rapid reduction of acute depressive symptoms in adults with major depression.

 Unlike standard antidepressants (SSRIs/SNRIs) that target monoamines like serotonin, dopamine, or norepinephrine, Spravato targets the NMDA receptor to regulate glutamate—the brain’s primary chemical messenger. This helps restore neural connections in brain regions associated with mood regulation. 

 Because of potential side effects such as sedation, dissociation, and temporary increases in blood pressure, Spravato is strictly administered under the Spravato REMS (Risk Evaluation and Mitigation Strategy) program. 

• Before beginning treatment, our Psychiatric Mental Health Nurse Practitioner conducts a comprehensive medical and psychiatric assessment to review your treatment history, check vital signs, and determine if Spravato is clinically appropriate and safe for you.

• You administer the nasal spray yourself under direct medical supervision in a comfortable, quiet treatment room.
• Devices are dosed in 28 mg increments (typically 56 mg or 84 mg per session).

• Following administration, you remain in our office for at least two hours.
• We monitor your blood pressure and ensure common temporary effects—like mild dizziness, floating sensations, or drowsiness—have resolved before discharge.

• You cannot drive, operate machinery, or make critical decisions until the following day after a restful night of sleep.
• A trusted driver must pick you up and take you home after every session.

•  Induction Phase (Weeks 1 – 4)
  2 sessions per week
• Transition Phase (Weeks 5 – 8)
  1 session per week
• Maintenance Phase (Week 9 & Beyond)
  Every 1 to 2 weeks (tailored to your clinical response)

 Is Spravato the same as ketamine?

Spravato is esketamine, the S-enantiomer of the ketamine molecule. It is specifically formulated as a nasal spray, rigorously evaluated in clinical trials, and FDA-approved for treatment-resistant depression. Unlike IV ketamine clinics, Spravato is covered by most major insurance providers when clinical criteria are met.

Does insurance cover Spravato?

Yes, most commercial insurance plans, Medicare, and many state plans cover Spravato for qualifying patients with documented treatment-resistant depression. Our office handles the prior authorization process and can assist with manufacturer savings programs (such as the Spravato withMe program for eligible commercially insured patients).

Who is not a candidate for Spravato?

Spravato is contraindicated for patients with known aneurysms (vascular defects), arteriovenous malformations, a history of intracerebral hemorrhage, or hypersensitivity to esketamine. It is also carefully evaluated in individuals with uncontrolled severe hypertension.

You don’t have to navigate persistent depression alone. Contact our office today to schedule a confidential consultation and find out if Spravato is the right fit for your treatment plan.