Spravato - Esketamine

Your Spravato® journey begins with a comprehensive psychiatric consultation and evaluation. During this first visit, one of our providers will review your medical and mental health history, discuss previous antidepressant treatments, and determine whether Spravato® is appropriate for your specific condition. Because Spravato® is approved for treatment-resistant depression and certain severe depressive episodes, eligibility criteria must be carefully reviewed before starting.

If you move forward, we will outline a personalized treatment plan and explain the REMS (Risk Evaluation and Mitigation Strategy) safety protocol required for this medication which requires all patients to stay under supervision for 2 hours. Spravato® is always administered in our clinic under medical supervision and must be used in combination with an oral antidepressant.

Once treatment begins, sessions are typically scheduled twice weekly for the first four weeks, followed by weekly treatments for a period of time depending on your response. During each appointment, you will self-administer the nasal spray under provider supervision while seated comfortably in a monitored treatment room. After administration, you will remain in the clinic for at least two hours so our team can observe your response, monitor blood pressure, and ensure your safety.

Some patients experience temporary sensations such as dizziness, sedation, or a feeling of dissociation during the monitoring period. These effects are expected, carefully monitored, and typically resolve the same day. Because temporary impairment may occur, you will need someone to drive you home after each session.

Over the course of treatment, improvements often develop gradually as brain connectivity and mood-regulating pathways respond to the medication. Your provider will track your progress closely and adjust the treatment frequency as clinically appropriate.