Spravato (Esketamine) For Severe Depression

Spravato (Esketamine) is an FDA-approved nasal spray approved in 2019 for adults with treatment-resistant depression and used alongside an oral antidepressant. By targeting the brain’s glutamate system rather than serotonin, it offers a fundamentally different way of addressing depression at the neural circuit level.

Given under supervision in a clinical setting, Spravato allows providers to safely deliver and monitor a treatment that may help patients who have felt stuck after years of trying other options. This makes it a meaningful advancement in care for individuals who need new possibilities when standard treatments have fallen short.

Who is Spravato For?

It is designed for adults whose depression has not improved with standard treatments and who continue to struggle despite trying multiple options. For these individuals, Spravato can offer an alternative path forward when other approaches have not been effective.

Spravato FAQ

Spravato® (Esketamine) FAQ

Who may qualify for Spravato® (esketamine)?+

Spravato is FDA-approved for adults with treatment-resistant depression (typically when symptoms have not improved after trying multiple antidepressants). Eligibility is determined during an evaluation with our provider to confirm Spravato is safe and appropriate for you.

How does Spravato work compared to traditional antidepressants?+

Many antidepressants primarily affect serotonin and may take weeks to work. Spravato targets the glutamate system (via NMDA receptor pathways) and may provide symptom relief more quickly for some patients. Every person responds differently, and our team will monitor your response closely.

Is Spravato covered by insurance?+

Spravato is often covered by many insurance plans, but coverage varies and typically requires prior authorization. Our team can help verify benefits and guide you through the approval process. Self-pay options may also be available.

What happens during a Spravato treatment visit?+

Spravato is administered in-office under medical supervision. You will self-administer the nasal spray as directed by the clinician, then you’ll relax in a comfortable setting while we monitor you for at least 2 hours to ensure safety before you leave.

Can I drive myself home after Spravato?+

No. You cannot drive or operate machinery on the day of treatment. You will need a responsible adult to drive you home after your visit.

What side effects should I expect?+

Common side effects can include dizziness, nausea, fatigue, headache, or a temporary feeling of dissociation (feeling “detached” or “spacey”). Some people may experience a temporary increase in blood pressure. Because of these possibilities, Spravato must be administered and monitored in a certified medical setting.

Do I need to stay on my antidepressant or therapy?+

Spravato is typically used alongside an oral antidepressant, and many patients continue therapy as well. Your provider will review your medications and treatment plan and recommend the safest, most effective approach for you.

How many treatments will I need?+

Treatment schedules vary by individual need and clinical guidance. Many patients start with more frequent visits early on, then transition to a maintenance schedule as symptoms improve. Your provider will discuss a plan tailored to your response and goals.

How should I prepare for my appointment?+

We may recommend avoiding food for a couple of hours beforehand to reduce nausea and arranging a ride home. Wear comfortable clothing and plan to take it easy for the rest of the day. Our team will provide specific instructions based on your situation.