Spravato® Treatment
When traditional antidepressants haven't provided adequate relief, additional treatment options may be available. Spravato® (esketamine) is an FDA-approved nasal spray used in combination with an oral antidepressant for adults with treatment-resistant depression and certain adults with major depressive disorder with acute suicidal thoughts or behaviors.
What Is Spravato®?
Spravato® is the brand name for esketamine, an FDA-approved prescription nasal spray that works differently from traditional antidepressants. It is FDA approved for adults with treatment-resistant depression and for certain adults with major depressive disorder accompanied by acute suicidal thoughts or behaviors. Unlike conventional antidepressants that primarily affect serotonin, Spravato® targets the glutamate system, offering a different approach for patients who have not experienced adequate improvement with standard treatments.
FDA-approved for treatment-resistant depression and certain adults with major depressive disorder with acute suicidal thoughts or behaviors.
FDA Approved
Spravato® is administered in our REMS-certified treatment center under the supervision of trained healthcare professionals. Each treatment session includes the FDA-required monitoring period to help ensure your safety.
Administered in Office
Every patient begins with a comprehensive psychiatric evaluation. Treatment includes ongoing monitoring, medication management, and regular follow-up to support long-term improvement throughout your course of care.
Comprehensive Care
Our team assists with insurance verification and prior authorization whenever required. We'll help determine your coverage and guide you through the approval process whenever possible.
Who May Benefit from Spravato®?
Spravato® is not appropriate for everyone experiencing depression. Every patient begins with a comprehensive psychiatric evaluation to confirm the diagnosis, review previous treatments, and determine whether Spravato® is an appropriate part of an individualized treatment plan.
Spravato® may be appropriate for adults with treatment-resistant depression who have not experienced adequate improvement despite appropriate trials of antidepressant medications.
Major Depressive Disorder with Acute Suicidal Thoughts or Behaviors
Spravato® is also approved for certain adults with major depressive disorder accompanied by acute suicidal thoughts or behaviors when used in conjunction with an oral antidepressant. Your provider will determine whether this FDA-approved indication is appropriate based on your individual clinical situation.
Not everyone experiencing depression is a candidate for Spravato®. A comprehensive psychiatric evaluation helps ensure that treatment recommendations are safe, appropriate, and individualized to your needs.
Comprehensive Evaluation Required
What to Expect During Treatment
Beginning Spravato® treatment is a step-by-step process designed to maximize safety while giving you the best opportunity for success. From your initial psychiatric evaluation through maintenance treatment, our team will guide you through every stage of your care.
Step 1
Comprehensive Psychiatric Evaluation
Every patient begins with a comprehensive psychiatric evaluation. During this appointment, we review your diagnosis, previous treatments, medical history, current medications, and treatment goals to determine whether Spravato® is an appropriate part of your individualized treatment plan.
Step 2
Insurance Verification & Prior Authorization
If Spravato® is recommended, our team will verify your insurance benefits and obtain prior authorization when required. We'll review your expected coverage, answer your questions, and coordinate your treatment schedule once approval has been received.
Step 3
Treatment is administered in our REMS-certified clinic under the supervision of trained healthcare professionals. Each visit includes self-administration of Spravato® under supervision, followed by the required observation and monitoring period before you are discharged with your designated driver.
Treatment Begins
Step 4
Most patients begin treatment with two sessions per week for the first four weeks. This induction phase allows your provider to monitor your response and determine the most appropriate ongoing treatment plan.
Induction Phase
Step 5
Following the induction phase, most patients transition to weekly treatments for approximately four weeks. During this phase, we continue monitoring your symptoms, evaluating treatment response, and adjusting your treatment plan based on your progress.
Optimization Phase
Step 6
Following the optimization phase, many patients transition to maintenance treatment once weekly and, when clinically appropriate, every other week. Treatment frequency is individualized based on symptom control, treatment response, and ongoing clinical assessment.
Maintenance Treatment
Preparing for Your Treatment
Arrange transportation with a responsible adult. Patients must not drive until the following day after a restful night's sleep.
Wear comfortable clothing. Dress in comfortable layers to help you relax during treatment.
Avoid eating for at least 2 hours and drinking liquids for at least 30 minutes before your appointment, unless instructed otherwise.
Take your regular medications as directed unless your provider has given different instructions.
Bring headphones, music, a book, or another quiet activity to enjoy during the observation period.
Before you arrive
Plan to rest for the remainder of the day.
Do not drive, operate machinery, or make important decisions until the following day after a restful night's sleep.
Follow all instructions provided by your treatment team before leaving the office.
Contact our office if you have any questions or concerns after your visit.
After Your Treatment
Treatment visits typically last approximately two hours to allow for medication administration and the required monitoring period. Please plan your schedule accordingly.
Your safety is our priority. Every Spravato® treatment is administered in our REMS-certified treatment center under the supervision of trained healthcare professionals in accordance with FDA safety requirements.
Safety & REMS Monitoring
Spravato® is available only through the FDA Risk Evaluation and Mitigation Strategy (REMS) Program. This FDA-required safety program helps ensure that treatment is administered in a certified healthcare setting with appropriate monitoring before patients return home.
Our practice is certified through the Spravato® REMS Program and follows all required safety and monitoring protocols established by the FDA and the manufacturer. Every treatment is administered under the supervision of trained healthcare professionals.
REMS-Certified Clinic
After receiving Spravato®, patients remain in our clinic for approximately two hours while our clinical team monitors blood pressure, level of alertness, dissociation, and overall recovery before discharge.
Two-Hour Observation
These safety requirements are part of the FDA-approved Spravato® REMS Program and apply to every treatment visit.
Because Spravato® may temporarily affect alertness, judgment, and coordination, patients must arrange transportation home after every treatment and should not drive until the following day after a restful night's sleep.
Transportation Home
Understanding insurance coverage can feel overwhelming. Our team works closely with patients and insurance companies to verify benefits, obtain prior authorization when required, and help guide you through the process from start to finish.
Before treatment begins, we'll verify your insurance benefits and explain your expected coverage, including deductibles, copayments, coinsurance, and any out-of-pocket responsibilities.
Benefit Verification
Many insurance plans require prior authorization before Spravato® treatment can begin. Our team coordinates with your insurance company to help obtain prior authorization and a coverage determination whenever required.
Prior Authorization Assistance
Insurance requirements can change throughout treatment. Our staff continues to assist with prior authorization renewals, benefit questions, and coverage updates whenever possible so you can focus on your care.
Ongoing Support
We participate with many commercial insurance plans, Medicare, and Ohio Medicaid plans. Visit our Insurance & Payment page, contact our office, or contact us online to verify your specific coverage.
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Spravato® (esketamine) is a prescription nasal spray approved by the U.S. Food and Drug Administration (FDA) for adults with treatment-resistant depression and for certain adults with major depressive disorder accompanied by acute suicidal thoughts or behaviors. It is administered only in certified healthcare settings through the REMS program and is used in combination with an oral antidepressant.
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Traditional antidepressants primarily affect serotonin, norepinephrine, or dopamine. Spravato® works differently by targeting the glutamate system, offering an alternative treatment approach for certain patients whose depression has not responded adequately to standard medications.
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Every patient begins with a comprehensive psychiatric evaluation. During this evaluation, we review your diagnosis, treatment history, medical conditions, current medications, and treatment goals to determine whether Spravato® is an appropriate option for your individual needs.
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Most patients begin with two treatments per week for the first four weeks, followed by weekly treatments for approximately four weeks. After that, many patients transition to maintenance treatment once weekly or every other week based on their symptoms, treatment response, and ongoing clinical assessment.
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Plan to be in our office for approximately two hours after receiving Spravato®. During this observation period, our clinical team monitors your blood pressure, overall recovery, and any temporary side effects before you are discharged.
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No. Because Spravato® may temporarily affect alertness, judgment, and coordination, you must arrange transportation home after every treatment. You should not drive or operate heavy machinery until the following day after a restful sleep.
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Many commercial insurance plans and Medicare provide coverage for Spravato® when medical necessity and coverage criteria are met. Our team will verify your benefits, obtain prior authorization when required, and explain your expected coverage before treatment begins.
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Every patient’s experience is different. Some people notice a sense of relaxation, changes in perception, or temporary dissociation during treatment. These effects are expected, are carefully monitored by our clinical team, and generally improve before you leave the office.
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Common side effects may include dizziness, dissociation, nausea, sleepiness, headache, increased blood pressure, or changes in perception. Most side effects are temporary and resolve during the observation period. Your treatment team will monitor you throughout each visit and answer any questions you may have.
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In many cases, yes. While Spravato® has historically been studied and approved for use in conjunction with an oral antidepressant for certain indications, treatment recommendations should always be individualized. At our practice, we generally recommend that patients continue their current medication regimen unless a change is clinically appropriate. Any medication adjustments will be discussed with you as part of your personalized treatment plan.
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If you miss a scheduled treatment, contact our office as soon as possible so we can help you reschedule. Your provider will determine whether any adjustments to your treatment schedule are necessary based on your progress and clinical needs.
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Spravato® is not appropriate for everyone. Before treatment begins, every patient undergoes a comprehensive psychiatric and medical evaluation to determine whether Spravato® can be administered safely and whether it is an appropriate treatment option.
Spravato® should not be used in patients with:
Aneurysmal vascular disease (including thoracic or abdominal aortic, intracranial, or peripheral arterial vessels)
Arteriovenous malformation (AVM)
A history of intracerebral hemorrhage
A known hypersensitivity to esketamine, ketamine, or any component of the medication
In addition to these FDA-listed contraindications, our practice carefully evaluates patients with certain psychiatric or medical conditions. Spravato® may not be appropriate for individuals with untreated Bipolar I disorder, active psychotic disorders such as schizophrenia, or other conditions where the potential risks may outweigh the expected benefits. A comprehensive psychiatric evaluation is required to determine whether Spravato® is appropriate for your individual situation.
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When administered in a REMS-certified healthcare setting, Spravato® has been shown to be a safe and effective treatment for appropriately selected patients. Before every treatment, our clinical team reviews your current health status, medications, and blood pressure, and monitors you throughout your visit for any temporary side effects such as dissociation, sedation, nausea, or increased blood pressure. Your safety remains our highest priority throughout every stage of treatment.
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The first step is to schedule a comprehensive psychiatric evaluation. If Spravato® is determined to be an appropriate treatment option, our team will guide you through insurance verification, prior authorization, scheduling, and every stage of your treatment journey.
Frequently Asked Questions
Still have questions?
We're here to help. Call us at (937) 912-5155 or request an appointment online to speak with a member of our team.
Ready to Explore Whether Spravato® Is Right for You?
If you've been living with depression despite trying traditional treatments, you don't have to navigate the next steps alone. Our team provides comprehensive psychiatric evaluations to determine whether Spravato® or another evidence-based treatment may be appropriate for your individual needs. We'll take the time to answer your questions, explain your options, and develop a personalized treatment plan focused on helping you move forward with confidence.
Compassionate care. Evidence-based treatment. Personalized for every patient.
Helping individuals and families throughout Beavercreek, Dayton, and Southwest Ohio find the right path forward.