Spravato® at a glance.
Spravato® (esketamine) is an FDA-approved nasal spray for treatment-resistant depression, given in our office under medical supervision.
You’ll relax in a comfortable, private room. Our team guides you through self-administering the nasal spray and monitors you closely for the next two hours, including routine blood pressure checks.
During this time you may notice a temporary rise in blood pressure, fatigue, or mild anxiety. About 60–70% of patients also experience dissociation, often described as a calm, “floaty,” or out-of-body feeling. For your safety, the FDA requires you to stay in the office for the full two-hour observation period.
Safety
Spravato® can cause side effects that need careful management, including sedation, dissociation, a brief rise in blood pressure, difficulty thinking clearly, or bladder issues.
It is given only through an FDA safety program, Spravato® REMS (Risk Evaluation and Mitigation Strategy), in which certified facilities like ours monitor patients during and right after treatment.
Ride-home policy
For the rest of your treatment day you will be alert and able to advocate for yourself, but your reflexes may be temporarily slowed.
Patients may not drive on the day of treatment. Please arrange a ride home with a family member, friend, or rideshare.
Who it’s for
Spravato® is for adults with treatment-resistant depression, with or without acute suicidal thoughts. We define treatment-resistant as having tried at least two antidepressants without significant improvement, or with side effects that outweighed the benefits.
Common questions.
What is Spravato®?
Spravato® is an FDA-approved nasal spray made from esketamine, a variant of ketamine, designed to treat depression. Because it is fast-acting and works differently from traditional oral antidepressants, it is self-administered in our office under medical supervision.
How does Spravato® work?
Traditional antidepressants rely on increasing serotonin or norepinephrine. Spravato® targets NMDA receptors in the brain, triggering the release of glutamate, a key neurotransmitter. This is thought to boost neuroplasticity, helping the brain form new connections and move past deeply ingrained negative thought patterns.
What is a treatment protocol?
Treatment begins with a one-month induction phase of two sessions a week, then tapers to once a week for the next two months. Studies show many patients start to see meaningful improvement at some point during these first three months.
After that, you return for regular maintenance sessions, likely less often, to sustain your progress and prevent relapse. The frequency is individualized by our Medical Director, Dr. Bystritsky.
Ask whether Spravato®
may be right for you.
A free consultation is a good place to start.