What Is Spravato? A Guide to Esketamine Treatment for Depression

What Is Spravato and How Does It Work?

If you or someone you love has struggled with depression that doesn't respond to traditional antidepressants, you're not alone — and there are now more options than ever. One of the most significant advances in recent years is Spravato® (esketamine), an FDA-approved nasal spray for treatment-resistant depression (TRD) and major depressive disorder (MDD) with suicidal ideation.

Unlike conventional antidepressants that target serotonin or norepinephrine, Spravato works on the brain's glutamate system — specifically NMDA receptors. This entirely different mechanism is why it can work for patients who haven't responded to other treatments.

Who Is Spravato For?

Spravato may be appropriate for adults who:

• Have tried two or more antidepressants without adequate relief (treatment-resistant depression)
• Are experiencing major depressive disorder with acute suicidal ideation
• Are looking for a faster-acting option — some patients notice improvement within hours to days

Your provider will conduct a thorough evaluation to determine if Spravato is right for your situation.

What to Expect During Treatment

Spravato is not a take-home medication. It is administered in a certified healthcare setting under direct medical supervision. Here's a typical session:

1. Self-administer the nasal spray under a provider's guidance
2. Rest and be monitored for approximately 2 hours for side effects such as dizziness or dissociation
3. Arrange a ride home — you cannot drive after treatment

Treatment schedule:

• Induction phase: Twice weekly for 4 weeks
• Maintenance phase: Once weekly for 4 weeks, then once weekly or every two weeks ongoing

How Quickly Does Spravato Work?

This is one of the most asked questions — and one of Spravato's most meaningful advantages. While traditional antidepressants can take 4–6 weeks to show effects, clinical studies have shown that some patients experience mood improvements within 24 hours of the first dose.

That said, individual results vary, and Spravato is most effective when used as part of a comprehensive treatment plan that may include therapy and oral antidepressants.

Is Spravato Covered by Insurance?

Yes — Spravato is covered by many major insurance plans, including Medicare and Medicaid, for patients who meet the clinical criteria. Our team will work with your insurance provider to verify coverage and help navigate prior authorization if needed.

Is Spravato Safe?

Spravato has been rigorously studied and is FDA-approved. The most common side effects include:

• Dissociation or feeling "detached"
• Dizziness or drowsiness
• Nausea
• Increased blood pressure (monitored during sessions)

These effects are typically short-lived and resolve within the observation period. Because of this, all treatments take place in our office — never at home.

Taking the Next Step

Living with treatment-resistant depression is exhausting — but breakthrough options like Spravato offer real hope. If you're wondering whether esketamine treatment could be right for you, we're here to help you find out.

Contact our office today to schedule a consultation and learn more about Spravato treatment at our practice.