Spravato for Treatment-Resistant Depression



Spravato (esketamine) is a recently released treatment for treatment-resistant depression (TRD). It is administered as a nasal spray, typically in conjunction with oral anti-depressants. Patients have shown a reduction in depression and suicidal ideation within just 24 hours from start of treatment, continuing to improve through the end of a four-week period. Sixty percent of patients have shown to have symptoms of depression reduced with continual treatment -- even after 80 weeks.

Spravato is given as an intranasal spray, which can be self-administered after consultation. For the first four weeks (induction phase), Spravato is to be taken twice weekly, then is only required to be administered once weekly or once every other week (maintenance phase).


Frequently Asked Questions

Is Spravato treatment right for me?

Spravato (esketamine) has been found to be useful for patients who have not experienced full relief of depression from at least two traditional antidepressant medications. Prior to being scheduled for Spravato, your provider will give you a full psychiatric evaluation to determine if you qualify for esketamine treatment.

What should I expect the day of my treatment?

You will be monitored very closely during your Spravato treatment. This will include blood pressure, pulse measurements, and some psychological measurements before and after your session.

A low dose of Spravato will be administered via intra-nasal spray. After five minutes another small dose will be administered. Your provider will monitor you for a two hour waiting period. We encourage you to wear eye shades, listen to relaxing music, and focus inward during this time.

Spravato's side effects wear off quite quickly; you will be able to return home about 2 hours after treatment is complete. Patients are required to have another person drive them home. You should not drive until the next day after a restful sleep.

What are the side effects?

During treatment, patients experience an altered mental state, feeling disconnected or in a dreamlike state. Some may experience a slight elevation in blood pressure, confusion, blurred vision, slurred speech, nausea, and vomiting. Most of these side effects usually subside shortly after the treatment.

Will my insurance cover Spravato treatment?

At this time we don’t know the cost, which insurances will cover it or the criteria that will need to be met for coverage. For more information regarding treatment costs for Spravato, please contact our office at (801) 369-8989.