When antidepressants
don’t work.
FDA-approved Spravato® works differently.
1 day
Most patients see improvement within 24 hours*
~69%
Response rate in patients treated with Spravato plus an oral antidepressant*
~53%
Patients achieve remission with continued treatment *
What is Spravato:
Spravato® (esketamine) is an FDA-approved nasal spray for adults with treatment-resistant depression and for adults experiencing acute suicidal thoughts. It can be used alone or with an antidepressant.
It targets the brain's glutamate system, working differently from conventional antidepressants and producing meaningful symptom improvement within hours to days for some patients.
Spravato is administered in our REMS-certified clinic under direct supervision. Each session involves about two hours of monitoring after administration. Most insurance plans cover treatment for eligible patients.
Spravato Benefits
- FDA-Approved
- Rapid-Acting (often within 24 hours)
- Non-invasive (nasal spray)
- Clinician Supervised (REMS-certified)
- Approved Alone or With Antidepressants
- Insurance Accepted
How Spravato Works and What Makes it Different:
Most antidepressants adjust serotonin or dopamine. Spravato works differently by targeting glutamate, a brain pathway research suggests is involved in depression. That's why it can help patients who haven't responded to oral antidepressants.
- Treatment: Twice-weekly sessions for the first month, then weekly maintenance.
- Each visit: 2 to 2.5 hours total, including the nasal spray administration and monitored recovery.
- Transportation: REMS requirements prohibit driving home. Arrange a ride in advance.
Your Spravato Treatment Timeline
What Happens During Your Treatment
2-3 Hour Appointment
Plan for a full morning or afternoon. Administration takes about 10 minutes, followed by 40 minutes of active effect and a monitored recovery period.
Clinical Supervision
Our clinical staff monitor your vitals and wellbeing throughout every session.
Relax in Our Treatment Rooms
A calm space designed for your comfort. Most patients listen to music or simply rest during the session.
Transportation Required
Important: REMS program requirements prohibit driving home after Spravato. Arrange a ride before your appointment.
Mental Health Care That Works With Your Insurance
TMS and Spravato (esketamine nasal spray) are covered by most major health insurance plans when criteria are met. For patients who are out-of-network or who want accelerated TMS treatment, third-party financing may be available.
A 5-minute screening tells you if TMS or Spravato may be a fit, verifies your insurance coverage, and connects you with our Patient Care Team to schedule your first appointment.
Spravato Frequently
Asked Questions
Q. Is Spravato the same as Ketamine?
A: Spravato contains esketamine, the S-enantiomer of ketamine. Both work on the same brain pathways, but Spravato is the only FDA-approved version specifically studied and approved for treatment-resistant depression and for depressive symptoms in adults experiencing acute suicidal ideation.
Developed by Janssen Pharmaceuticals, Spravato received FDA approval in March 2019 and, in January 2025, became the first treatment FDA-approved as monotherapy for treatment-resistant depression. Spravato is administered as a nasal spray in REMS-certified clinics.
Q. What are the side effects of Spravato?
A: Common side effects include dissociation (a temporary feeling of being disconnected from yourself or your surroundings), dizziness, nausea, sedation, increased blood pressure, headache, anxiety, and altered perception.
The dissociative experience varies by person. Some describe it as floating or dream-like; others find it disorienting at first.
Our clinical team monitors you throughout each session.
Q. Will I need to take Spravato forever?
A: Duration varies by individual. Many patients move to weekly or bi-weekly maintenance, while others taper off under medical supervision.
Your treatment plan is reviewed and adjusted as you progress.
Q. Is Spravato (esketamine) safe? What should I expect during a session?
A. Spravato is FDA-approved and is administered under direct medical supervision in our clinic. You will self-administer the nasal spray under Dr. Roth’s or one of our clinician's oversight and remain in our clinic for a two-hour monitoring period following each dose.
Most patients experience mild dissociative effects or dizziness that resolve before they leave. You cannot drive on the day of a Spravato session, so you will need a ride home.
Spravato is approved as a monotherapy for treatment-resistant depression and as an add-on treatment with an oral antidepressant.
It works through a different brain pathway than traditional antidepressants, providing rapid-acting relief for patients who have not responded to other treatments.
Q. Can I take my other medications while on a Spravato treatment?
A: For treatment-resistant depression, Spravato can now be used as monotherapy OR alongside an oral antidepressant (per the January 2025 FDA approval).
For the second indication, MDD with acute suicidal ideation, Spravato is used in combination with an oral antidepressant.
Either way, you will discuss the best approach with your clinician.
Compare Treatments
A side-by-side look at TMS, Spravato, medication, and therapy - who they help, how fast they work, and what to expect.
Is TMS Right For Me?
A quick self-screen to see if TMS might fit your symptoms, prior treatments, & medical profile.
