Spravato Treatment

Spravato nasal spray is indicated for the treatment of depression in conjunction with oral antidepressant in adults who have failed treatment with at least two antidepressants (treatment resistant depression). It is also indicated in adults with major depressive disorder with acute suicidal ideation or behavior.

If you are seeking treatment for any of the above indications and you are not at the risk of having serious side effects with Spravato, it may be a good treatment option for you.

Please schedule an appointment with one of our providers to determine whether Spravato would be a good treatment option for you.

No, you will continue to take your oral antidepressant medication as before. Spravato nasal spray is approved for the treatment of depression in conjunction with oral antidepressant medication

Depending on your insurance plan, your insurance may cover Spravato treatment. Blue Cross Blue Shield (BCBS), Medicare, and Aetna are some of the insurances that are currently covering Spravato treatment. Before starting treatment, our benefits verification team will determine eligibility and benefits with your insurance, including any out of pocket costs that you may incur during treatment. It may take 1-2 weeks to get approval for Spravato from your insurance.

Some patients taking Spravato may experience nausea or vomiting. You should avoid eating two hours before and drinking liquids 30 minutes before taking Spravato.

If you take a nasal corticosteroid or nasal decongestant medicine, take these medicines at least one hour before taking Spravato. You should also request a family member or friend to drive you to and back from each appointment.

Spravato is administered as a nasal spray by the patient under direct clinical supervision of the healthcare provider in the medical office setting. The provider will tell you how to use the device and how much Spravato to take.

After each administration, you will be monitored in the office for about 2 hours. If the provider decides that it’s safe for you to leave office, then you should have a family member or a friend drive you back home from office.

In most cases, the treatment lasts about 8 weeks. Spravato is administered twice per week in the first 4 weeks and once every week from week 5-8.

Depending on your progress, if further maintenance treatment is required, your healthcare provider will discuss treatment options with you.

Each Spravato administration appointment typically lasts about 2 hours.

Spravato contains esketamine hydrochloride, which has a chemical formula that is a mirror image of ketamine. It is designated as a Schedule III controlled substance under the Controlled Substances Act and therefore it may carry serious risk of abuse and misuse. Some patients may experience one or more of the following side effects with Spravato:

• Sedation or sleepiness
• Dizziness – fainting or spinning sensation
• Dissociation – feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation)
• Increase in anxiety
• Physical and psychological dependence
• Nausea and vomiting
• Increased blood pressure
• Feeling drunk
• Decreased sensitivity (numbness)
• Lack of energy
• Increased suicidal thoughts and actions
• Difficulty in urination

Spravato is not recommended for patients with the history of treatment for ballooning or bulging blood vessels (aneurysms), bleeding due to brain injury, and hypersensitivity to esketamine or ketamine or ingredients in esketamine spray.