Spravato Nasal Spray

Spravato is a prescription nasal spray containing esketamine, a medicine that works differently from traditional antidepressants. Instead of targeting serotonin, it acts on the brain's glutamate system (as an NMDA receptor antagonist), which is believed to help restore connections between brain cells involved in mood.

It is FDA-approved for adults with treatment-resistant depression (TRD), meaning depression that has not improved enough after trying at least two different antidepressants, either on its own or alongside an oral antidepressant. It is also approved, with an oral antidepressant, to treat depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or actions.

Because of the risk of sedation, dissociation and blood pressure changes, Spravato is only available through a restricted FDA safety program (REMS) and must be taken in a certified healthcare setting. You use the device yourself under staff supervision, and we monitor you for at least two hours afterward in a calm, comfortable space.

A typical schedule begins with two sessions per week for the first four weeks (induction), then weekly sessions for weeks five through eight, and then weekly or every-other-week maintenance based on your response. Your provider will tailor the plan to you.

Spravato is part of a whole-person plan. It pairs naturally with our psychiatric medication management and counseling services so we can track progress, adjust medications and support lasting recovery.

You cannot drive or operate machinery on treatment days until the next day after a restful sleep, so please arrange a ride home. Many insurance plans cover Spravato with prior authorization, and our team will help you navigate the process.