Spravato (esketamine)
Spravato is an FDA-approved nasal spray for adults with depression that hasn't responded to standard antidepressant treatment, as well as depression accompanied by suicidal thoughts. Unlike traditional antidepressants, which can take weeks to start working, Spravato can begin improving symptoms in as little as 24 hours for some patients. It can be used alone or alongside an oral antidepressant, and your provider will work with you to determine if it's the right fit for your care.
Is Spravato Right for You?
Spravato is typically considered for adults who have tried at least two other antidepressant medications without adequate relief, or who are experiencing depression with suicidal thoughts. Your provider will review your history and current treatment to determine eligibility together with you.
What to Expect
Because of how Spravato works, it can only be given in a certified medical office — it is never sent home with patients. Here's what a typical visit looks like:
You self-administer the nasal spray under the direct supervision of our clinical team
You remain in the office for a required monitoring period of at least 2 hours after your dose, during which we check in on how you're feeling
You cannot drive yourself home the day of treatment — please arrange a ride in advance for every session
Most patients begin with sessions twice a week for the first several weeks, then move to a less frequent maintenance schedule as your provider determines what works best for you
These monitoring requirements aren't optional clinic preferences — they're part of a federally mandated safety program (REMS) required for all Spravato treatment nationwide.
Before Your First Dose
All patients must be enrolled in the Spravato REMS Program before treatment can begin. This involves a one-time enrollment form and a conversation with your provider about the treatment's risks, benefits, and what to expect. We'll walk you through this step by step.
Cost and Insurance
Coverage for Spravato varies by plan. We encourage you to verify your behavioral health benefits and confirm in-network status before starting treatment — our team can help guide you through this process.
