Spravato® (Esketamine Nasal Spray)
FDA-Approved Relief for Treatment-Resistant Depression
Spravato® (esketamine) is the first and only FDA-approved nasal spray specifically for adults with treatment-resistant depression. It is not a take-home medicine; it must be administered in certified clinics under the REMS safety program to ensure proper monitoring.
Unlike traditional oral antidepressants, Spravato® works on NMDA receptors to help restore healthy brain signaling and can provide faster symptom relief for people who haven’t responded to standard treatments. In January 2025, the FDA expanded its approval to allow standalone use in some cases without a conventional antidepressant.
Indications & Administration
Spravato® (esketamine nasal spray) is approved for adults whose depressive symptoms have not improved despite at least two different oral antidepressant treatments. This makes it a next-step option for treatment-resistant depression.
How it is given:
- Administered intranasally in a certified clinic – never at home.
- Typical starting dose is 56 mg, which may be increased to 84 mg depending on the patient’s needs.
- Each dose is self-administered under direct supervision of trained staff.
- After each session, patients stay in the clinic for at least two hours. During this time staff monitor for dissociation, sedation, changes in blood pressure and any other side effects.
Clinical Outcomes & Maintenance
Clinical studies show that some patients experience noticeable symptom improvement as early as four hours after the first dose. In longer-term use, esketamine has demonstrated effectiveness in maintaining antidepressant benefits and reducing the risk of relapse.
Treatment begins with an induction phase, usually twice-weekly sessions for the first few weeks. After that, dosing is tapered gradually to weekly or every one to two weeks according to the clinician’s judgment and the patient’s response.
What to Expect at Elevated Health
Insurance & Coverage
Spravato® may be covered under many insurance plans. Our staff can help verify your benefits and guide you through the approval process.
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Expertise & Team
Clinical Psychologist
Clinical Psychologist
Clinical Psychologist
Clinical Psychologist
Our Services
Service
IV Ketamine Infusion
Key Use
Rapid relief for depression, PTSD, and severe anxiety
Onsite Observation
~2 hours monitored by medical staff
What to Expect
Subanesthetic doses infused with careful monitoring of vital signs in a supportive environment
Rapid/Clinical Outcome
Many patients notice improvement within 24 hours
Service
Spravato® (Esketamine Nasal Spray)
Key Use
FDA-approved therapy for adults with treatment-resistant depression
Onsite Observation
2+ hours under REMS protocol for safety monitoring
What to Expect
Supervised nasal spray administration with monitoring for sedation, dissociation, and vital signs
Rapid/Clinical Outcome
Proven effectiveness in maintaining symptom relief and reducing relapse risk