What is Spravato?

Spravato (esketamine) is a nasal spray administered in-office by a healthcare professional to treat patients suffering from treatment-resistant depression or acute suicidal ideation.


It is not known exactly how the medication Spravato works, but we do know that it is a NMDA receptor antagonist that is unique in the respect that it acts on a pathway in the brain that affects glutamate, the most abundant neurotransmitter in the brain.Spravato is meant to be used in adjunct with an antidepressant.

Who would benefit from Spravato treatment?

  • Currently, Spravato treatment is only FDA approved for patients suffering from treatment-resistant depression and acute suicidal ideation.
  • Spravato treatment is not indicated to treat Bipolar Disorder.
  • Patients who have failed two or more classes of antidepressants qualify for Spravato treatment.

What are possible side effects of Spravato?

Patients are required to stay at the office for a minimum of two hours following the administration of Spravato. During that time, patients will be monitored by staff for side effects.


The most common side effects seen in our office are nausea, sedation, and dissociation. Dissociation can be a distressing experience for a patient where they feel disconnected from reality.

Other possible side effects include: Increased blood pressure, numbness, anxiety, etc. Your provider will discuss all possible side effects before the start of Spravato treatment.

Who should not receive Spravato treatment?

  • Patients not diagnosed with treatment-resistant depression or not currently experiencing suicidal ideation.
  • A patient with a current diagnosis or past history of an intracranial bleed or vascular aneurysm.

What insurances are accepted for this treatment?

We accept almost all major commercial insurances, Medicare, Tricare, and are in the process of getting approval for Medicaid patients specifically for Spravato treatment. Unfortunately, we do not accept UHC at the moment for Spravato treatment.

What do I need to do in preparation for my first Spravato treatment session?

An appointment discussing the risks/benefits of treatment, all available treatment options, and to sign the appropriate paperwork must be completed prior to your first session.

A “Spravato Intranasal Therapy” consent form must be signed.
The patient must be enrolled in the Spravato REMS safety program.
It is advised that our patients utilizing their pharmacy benefits to pay for Spravato treatment sign up for the Spravato copay card.