Spravato® is the brand name for esketamine, a prescription nasal spray used to treat certain adults with depression. It is related to ketamine but is a distinct medication with specific FDA-approved uses and safety requirements.

Spravato® is administered only in a certified healthcare setting. You take the medication yourself under supervision and remain at the clinic for monitoring afterward.

Spravato® affects the brain’s glutamate system, including receptors involved in communication and adaptability between brain cells. This is different from the primary mechanism of most traditional antidepressants.

Some patients experience improvement early in treatment, but response times vary. Spravato® does not work for everyone, and a full treatment course and ongoing clinical assessment are usually needed to understand how well it is working for you.

Spravato® is FDA-approved for adults with treatment-resistant depression. It may be used by itself or with an oral antidepressant.

It is also approved, together with an oral antidepressant, for depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behavior. Spravato® has not been shown to prevent suicide or replace hospitalization when hospitalization is clinically necessary.

Your clinician will determine whether you meet the medical and insurance criteria for treatment.

Spravato® contains esketamine and is given as a nasal spray. IV ketamine contains racemic ketamine and is delivered into a vein.

Spravato® has FDA-approved indications for certain forms of depression and is provided under a formal Risk Evaluation and Mitigation Strategy (REMS) program. IV ketamine treatment for depression is an off-label use.

Spravato® is generally covered under most major insurance companies, including Medicaid and Medicare, although authorization requirements and out-of-pocket costs vary. IV ketamine is self-pay.

Treatment usually begins more frequently and becomes less frequent over time. A common schedule for treatment-resistant depression is:

• Twice weekly during the first four weeks
• Once weekly during weeks five through eight
• Once weekly or every other week beginning in week nine

Your clinician may adjust the schedule based on your response, side effects, diagnosis, and insurance requirements. The goal is to use the least frequent schedule that maintains meaningful improvement.

Common temporary side effects include dissociation, dizziness, nausea, sleepiness, increased blood pressure, anxiety, headache, altered taste, and changes in perception. We offer lollipops during treatment to help with the taste.

Spravato also carries some potential for misuse, which is why it’s only available through certified treatment centers like ours. Your clinician will review your health history and medications before every treatment.

You’ll be monitored on-site for at least two hours after each dose (longer if medically needed), since sedation and altered awareness can occur. You cannot drive or operate machinery until the following day, after a full night’s sleep.

Many commercial insurance plans, Medicare plans, and Medicaid programs may cover Spravato® when their medical-necessity requirements are met, though coverage is never guaranteed.

Insurers may require documentation of your diagnosis, previous antidepressant trials, current treatment plan, and prior authorization, which our team gathers during your initial consultation visit. Your responsibility may include a deductible, copayment, coinsurance, or charges for clinical monitoring.

Our team can help verify your benefits and explain anticipated costs before treatment begins.