Who may be eligible for Spravato?
Spravato (esketamine) is approved by the FDA for adults with treatment-resistant depression—usually meaning depression that hasn’t improved enough after at least two antidepressants—and, alongside an oral antidepressant, for adults with major depression who have acute suicidal thoughts or behaviors. Your psychiatrist will review your history to see whether it’s a good fit.
Eligibility is assessed by looking at:
- Past antidepressant trials
- Current diagnosis & symptoms
- Blood pressure history
- Vascular or brain conditions
- Substance use history
- Pregnancy or plans for pregnancy
What is Spravato treatment like?
Inside a treatment session
Spravato is given only in certified healthcare settings, where you use the nasal spray yourself under the direct observation of our clinical team. Each visit includes:
After the dose, you relax in a comfortable chair while we keep an eye on how you’re feeling and check your blood pressure. Spravato can cause dissociation, dizziness, nausea or sleepiness, so we monitor you for at least two hours and only send you home once you’re ready. You shouldn’t drive or operate machinery until the next day, after a restful night’s sleep. Treatment usually starts with two sessions a week for the first month, then becomes less frequent.
What sets Spravato apart
Esketamine is a form of ketamine developed specifically as a nasal spray for depression, and it is the only ketamine-based treatment approved by the FDA for this purpose. Because it went through FDA review, its dosing, safety monitoring and clinic requirements are clearly defined. Here is what that means for you:
FDA-Approved
Spravato has been studied in clinical trials and approved for specific uses, with clear guidance on dosing and safety.
Certified Clinic
We follow the Spravato REMS safety program, which sets out how the medicine is stored, given and monitored in our clinic.
Common Side Effects
Dissociation, dizziness, nausea, sleepiness and higher blood pressure are possible, and usually ease within the visit.
Ongoing Care
Spravato is one part of your plan, alongside an antidepressant where prescribed, therapy and regular check-ins with your psychiatrist.
When Spravato may be worth discussing
Signs to raise with your psychiatrist
- Two or more antidepressants tried
- Depression that keeps returning or never fully lifts
- Partial relief at best
- Persistent low mood
- Loss of interest or pleasure
- Difficulty working or studying
- Low energy most days
- Ongoing feelings of worthlessness
In their own words
Experiences shared by our clients
Theo – project manager
Isla – ceramic artist
Rosa – teacher
Lucas – software engineer
Ivy – illustrator
Nora – writer
Owen – entrepreneur
Frequently
Asked Questions
Questions about Spravato
Q1: How is Spravato different from ketamine?
Esketamine is one of the two mirror-image forms that make up ketamine. Spravato is a nasal spray approved for depression; IV ketamine is used off-label.
Q2: How often are treatment sessions?
Usually twice a week for the first four weeks, then weekly for the next four, and after that weekly or every other week, depending on your response.
Q3: Why do I need to stay for two hours?
Side effects such as dissociation, dizziness or raised blood pressure are most likely in the first couple of hours, so we monitor you until they’ve passed.
Q4: Can I drive after a session?
No. Please arrange a ride home. You shouldn’t drive or use machinery until the next day, after a restful night’s sleep.
Q5: Do I keep taking my antidepressant?
Often, yes—Spravato is commonly used alongside an oral antidepressant. Your psychiatrist will advise based on your plan.
