Spravato® Therapy
A breakthrough nasal spray treatment for adults with treatment-resistant depression. When antidepressants haven't worked, Spravato offers a new path forward.
About the Treatment
What Is Spravato®?
Spravato® (esketamine) is an FDA-approved prescription nasal spray used alongside an oral antidepressant to treat adults with treatment-resistant depression (TRD) — depression that has not improved after trying at least two different antidepressant medications.
It is also approved for adults with major depressive disorder (MDD) with acute suicidal ideation or behavior, offering rapid relief when it's needed most.
Unlike traditional antidepressants that can take weeks to work, Spravato acts on the NMDA receptor — a different pathway in the brain — and many patients experience meaningful improvement within hours to days of their first treatment.
FDA-Approved
Approved for treatment-resistant depression and MDD with suicidal ideation.
Novel Mechanism
Works on NMDA receptors — a different pathway than traditional antidepressants.
Rapid Relief
Many patients see improvement within hours to days of starting treatment.
Insurance Covered
Covered by most major insurance plans including Medicare and Medicaid.
Eligibility
Who May Qualify?
Spravato may be right for you if you meet one or more of the following criteria.
You have been diagnosed with major depressive disorder (MDD)
You have tried at least 2 antidepressant medications without adequate relief
You are currently experiencing or at risk for acute suicidal ideation
You are an adult (18 years or older)
You are able to commit to in-office treatment sessions
You have a responsible adult who can drive you home after sessions
The Process
How Treatment Works
Spravato is always administered in a certified healthcare setting under medical supervision — never at home.
Evaluation
A thorough psychiatric evaluation determines if Spravato is appropriate for you based on your diagnosis, treatment history, and health profile.
Insurance & Prior Authorization
Our team handles the prior authorization process with your insurance provider to confirm coverage before treatment begins.
In-Office Treatment Session
You self-administer the nasal spray under direct medical supervision in our office. Sessions last approximately 2 hours.
Monitoring & Follow-Up
You are monitored for at least 2 hours after each dose. Our team tracks your progress and adjusts your treatment plan as needed.
Typical Treatment Schedule
Induction phase: Twice weekly for 4 weeks · Maintenance phase: Once weekly for 4 weeks, then once every 1–2 weeks. Your psychiatrist will tailor the schedule to your response and needs.
Important Safety Information
- Spravato is only available through a certified healthcare provider under the REMS program.
- Do not drive or operate heavy machinery on the day of treatment.
- You must be monitored for at least 2 hours after each dose.
- Spravato may cause dissociation, dizziness, nausea, or sedation.
- It is not approved for use in children or adolescents under 18.
- Tell your provider about all medications you are taking before starting treatment.
Spravato® is a registered trademark of Janssen Pharmaceuticals, Inc. This page is for informational purposes only and does not constitute medical advice.
Common Questions
Frequently Asked Questions
Who is a candidate for Spravato?
Spravato is FDA-approved for adults with treatment-resistant depression (TRD) — meaning depression that has not responded to at least two different antidepressant treatments — and for adults with major depressive disorder (MDD) with acute suicidal ideation or behavior.
How is Spravato different from ketamine infusions?
Spravato (esketamine) is an FDA-approved nasal spray derived from ketamine. Unlike IV ketamine infusions, Spravato is self-administered under supervision and is covered by many insurance plans. It is specifically approved for treatment-resistant depression.
How quickly does it work?
Many patients report improvement in depressive symptoms within hours to days of their first treatment. The induction phase (twice weekly for 4 weeks) is designed to establish a therapeutic effect, followed by a maintenance schedule.
Is Spravato covered by insurance?
Yes — Spravato is covered by most major insurance plans including Medicare and Medicaid for qualifying patients. Our team will verify your benefits and handle prior authorization before treatment begins.
Can I drive after a session?
No. You must arrange for a responsible adult to drive you home after each session. You should not drive or operate heavy machinery on the day of treatment due to potential sedation and dissociation.
How long is each treatment session?
Plan for approximately 2–2.5 hours per visit. This includes the self-administration of the nasal spray and a mandatory 2-hour monitoring period in our office.