If you’ve been struggling with treatment-resistant depression and haven’t found relief from traditional antidepressants or talk therapy, you may be wondering:

What else is out there?
Enter Spravato®, a prescription nasal spray containing esketamine — a form of ketamine approved by the FDA for treatment-resistant depression (TRD). Unlike most antidepressants that can take weeks to work (and sometimes never do), Spravato® works differently — and for many, it works faster.

Let’s break down what Spravato® therapy is, how it works, and whether it might be the right next step in your healing journey.

What Is Spravato®?
Spravato® is the brand name for esketamine, a derivative of ketamine that’s administered as a nasal spray under medical supervision. It was FDA-approved in 2019 for adults with:

• Treatment-resistant depression (TRD) — meaning you’ve tried at least two
antidepressants without success.
• Major depressive disorder (MDD) with suicidal thoughts or behavior (in some cases).

It is not a take-home medication. Spravato® must be administered in a certified treatment center
where you are monitored for at least 2 hours after each dose.

How Does Spravato® Work?
Most antidepressants target serotonin or norepinephrine. Spravato® works differently — it targets the NMDA receptor in the brain, affecting glutamate, the most abundant neurotransmitter in your brain. This shift helps promote:

• Rapid neuroplasticity — the brain’s ability to form new connections.
• Breakthroughs in mood and thinking patterns that feel stuck.
• Reduction in suicidal ideation in acute cases.

Many patients report feeling relief within hours or days — especially significant for those who have been in the dark for a long time.

What to Expect During Spravato® Therapy

Here’s a typical experience:
1. 2. 3. 4. 5. Evaluation: Your provider will determine if you’re a candidate based on your medical history and treatment background.

In-Clinic Sessions: You'll self-administer the nasal spray under supervision, then rest in a calm, private space for observation.

Duration: Each session lasts about 2 hours, including the monitoring period.
Frequency: Spravato® therapy usually starts with twice-weekly sessions for 4 weeks, then tapers to weekly or biweekly.

Integration Support: While Spravato® helps with rapid symptom relief, it's most effective when combined with therapy or counseling.

* Because of potential side effects like dissociation, dizziness, or sedation, you cannot drive
home after a session — so plan for a ride.

Is Spravato® Safe?
Yes - Spravato® is FDA-approved and administered only in certified clinics due to its potency and potential for misuse. That means you’ll always be monitored by trained professionals during and after each session.

Common side effects may include:
• Dizziness or nausea
• Dissociation (a dreamlike state)
• Increased blood pressure
• Fatigue or sedation

These effects are temporary and typically subside within a few hours.

Is Spravato® Covered by Insurance?
Yes — most insurance plans, including Medicare and Medicaid, cover Spravato® for patients who meet criteria for treatment-resistant depression. Clinics typically help navigate prior authorizations and benefits verification.

Who Should Not Take Spravato®?
Spravato® may not be appropriate for people with:
• A history of psychosis
• Uncontrolled high blood pressure
• Substance use disorder (in some cases)

Your provider will go through a full medical screening to assess safety.
Spravato® represents a new frontier in mental health care — offering hope to people who’ve felt like they’ve run out of options. While it’s not a magic cure, it can be a powerful catalyst for healing when used as part of a comprehensive treatment plan.

​If you’ve been stuck in the cycle of trying medication after medication without results, Spravato® may offer the shift you’ve been waiting for.