Spravato® (Esketamine) Treatment for Depression
For Adults with Treatment-Resistant Depression
NOTE: We are now opening for evening hours in our spravato clinic for patients who are professionals or cannot take time off to receive this treatment. Click here to view our new hours.
What is Spravato®?
Spravato (esketamine) is an FDA-approved treatment for adults with treatment-resistant depression and depressive symptoms associated with major depressive disorder with suicidal thoughts or behaviors.
Spravato works differently than traditional antidepressants. Instead of working on serotonin alone, Spravato affects glutamate, a neurotransmitter involved in brain connectivity and mood regulation. This can help the brain form new connections and improve mood more rapidly in some patients.
Spravato is given as a nasal spray in a medical office under supervision, followed by a monitoring period.
Who is a Candidate for Spravato®?
Spravato may be appropriate if you:
- Spravato was approved by the FDA as monotherapy (no other medication needed) in 2025
- Have tried two or more antidepressants without enough improvement
- Have treatment-resistant depression
- Have moderate to severe depression that has not responded to other treatments
- Are currently taking an oral antidepressant (again some insurance companies are not requiring this after the FDA approval)
- Can attend in-office treatment appointments
- Can find a ride or use a service such as UBER due to not being able to drive the rest of the day after the treatment.
Spravato may not be appropriate if you have:
- Certain uncontrolled medical conditions
- History of aneurysm or certain vascular conditions
- Certain substance use conditions (case-by-case)
- Uncontrolled high blood pressure
What Treatment is Like
- Treatment is done in our office
- You self-administer the nasal spray under supervision
- You are monitored for 2 hours
- You will need a driver to take you home
- Many patients listen to music or rest during treatment
- Our staff monitors blood pressure and how you are feeling throughout the visit
- Our clinicians and RN are trained in grounding techniques should you find the experience unsettling, or anxiety provoking
- Our head clinical lead is trained and certified in Ketamine Assisted Psychotherapy
Typical Schedule:
- Weeks 1–4: 2 treatments per week (Induction)
- Weeks 5–8: 1 treatment per week (Optimization)
- Maintenance: 12 weeks through 52 weeks on average based off the clinical trial
Why Choose Our Spravato® Program
Choosing where you receive Spravato treatment is important. Spravato is not just a medication — it is a treatment that requires careful monitoring, psychiatric oversight, and long-term planning.
Does Spravato® Work?
Spravato has been studied in patients with treatment-resistant depression who did not respond to traditional antidepressants.
Clinical studies show:
- Many patients experience improvement within weeks
- Some patients experience improvement within 24–48 hours
- Spravato, combined with an oral antidepressant, is more effective than an antidepressant alone in treatment-resistant depression
- Many patients continue maintenance treatment to sustain improvement
Spravato is one of the few treatments shown to help patients with treatment-resistant depression and depression with suicidal thoughts.
Spravato® vs Traditional Antidepressants
Traditional Antidepressants
- Taken daily at home
- Work on serotonin, norepinephrine, or dopamine
- May take 6–8 weeks to work
- Many patients require multiple medication trials
Spravato®
- Administered in a medical office
- Works on glutamate and brain connectivity
- May work more rapidly in some patients
- Used for treatment-resistant depression
- Given with an oral antidepressant
Spravato is often used when multiple medications have not worked well enough.
Maintenance Spravato® - What Happens after the First 2 Months?
Depression is often a recurrent illness, so many patients continue maintenance Spravato after the initial phase.
When you refer a patient:
- Weekly treatments
- Then every other week
- Some patients continue every 2–4 weeks
- Treatment frequency is adjusted based on symptoms
Our goal is stability and relapse prevention, not just short-term improvement.
For Referring Providers
We work collaboratively with psychiatrists, primary care providers, and therapists.
When you refer a patient:
- The patient receives a psychiatric evaluation
- We manage REMS requirements and prior authorization
- We provide updates on patient progress
- Medication management can remain with the referring provider if preferred
- After stabilization, patients may return fully to the referring provider
- We remain available for maintenance treatment
Am I a Spravato® Candidate? (Quiz)
Answer the following questions:
If yes to most → You may be a candidate.
Insurance & Cost
- Spravato is covered by many major insurance plans
- We complete prior authorization and REMS requirements
- We review your benefits before starting treatment
- Patient assistance programs may be available
Contact Us
If you have been struggling with depression that has not improved with medications, Spravato may be an option. The first step is a consultation where we review your history, prior treatments, and insurance coverage and help determine if this treatment is appropriate for you.