Month 1
Month 1
Two treatments per week.
Esketamine / SPRAVATO
An FDA-approved nasal-spray treatment for adults whose depression has not improved enough with standard care.
What Is Spravato?
A different treatment path for treatment-resistant depression.
SPRAVATO is an FDA-approved nasal spray containing esketamine. It is approved for adults with treatment-resistant depression, either by itself or together with an oral antidepressant, and for certain adults with major depressive disorder with suicidal thoughts or actions when used with an oral antidepressant.
Esketamine works differently than conventional antidepressants. Instead of following the same serotonin-centered path, it acts through glutamate signaling and may offer relief when standard options have not been enough.
BioMental Clinic reviews diagnosis, prior medication trials, current medications, treatment goals, insurance requirements, and monitoring needs before the first treatment is scheduled.
SPRAVATO is administered in the office under supervision, not taken home for unsupervised use.
Treatment Plan
How treatment usually works
Esketamine treatment is given in the office, with the nasal spray administered under the supervision of a certified provider.
The starting dose and later dosing depend on the indication, response, and tolerability. Visits are more frequent during the first month and usually become less frequent over time.
Month 2
Month 2
One treatment per week.
Month 3+
Month 3+
Continue weekly treatment or space visits to once every two weeks based on clinical response.
Treatment Day
What to expect during a visit
Plan to spend about two hours in the office after the medication is given so the team can monitor you during the observation period.
Temporary effects such as dizziness, dissociation, nausea, or sedation can happen shortly after treatment and usually wear off the same day.
Please plan for
- A ride home after each treatment
- About two hours in the office for monitoring
- A quiet recovery period after the nasal spray
- No driving until the next day after a restful sleep
Before Starting
Important screening and safety points
Before starting, tell your provider about your full depression treatment history, all current medications, and any past problems with alcohol, prescription misuse, or street drugs.
Patients should also discuss major heart, brain, or liver problems, psychosis, pregnancy, and breastfeeding before treatment begins.
Because nausea and vomiting can occur, patients are instructed to avoid eating for two hours before treatment and avoid drinking liquids for 30 minutes beforehand.
Before Starting
SPRAVATO may not be appropriate if you have
- A blood vessel disorder such as an aneurysm
- An arteriovenous malformation
- A history of bleeding in the brain
- An allergy to esketamine, ketamine, or related ingredients
Getting Started
How to get started with esketamine at BioMental Clinic
If SPRAVATO / esketamine sounds like a reasonable option, these are the next steps:
Getting Started
- Request a SPRAVATO / esketamine consult
- Become a patient.
- Complete insurance verification and pre-authorization.
- Schedule the first treatment.
Frequently Asked Questions
Frequently Asked Questions
What is treatment-resistant depression?
Treatment-resistant depression generally refers to adults with major depressive disorder who have not responded adequately to at least two antidepressants of adequate dose and duration during the current depressive episode.
How is SPRAVATO nasal spray different than ketamine infusion?
SPRAVATO is an FDA-approved nasal spray containing esketamine and is administered under a REMS program. Ketamine infusions use a related medication in a different format and are not the same FDA-approved product for depression.
What personal items can I bring to my treatment session?
Patients can bring comfort items such as headphones, music, a tablet, a book, puzzles, a blanket, or a pillow to help pass the time during observation.
What happens during the observation period after taking SPRAVATO?
Observation begins immediately after treatment. Patients rest comfortably while the care team monitors side effects and checks blood pressure during the visit.
What side effects could I experience on SPRAVATO?
Common effects can include dissociation, dizziness, nausea, sleepiness, spinning sensations, numbness, anxiety, low energy, vomiting, and feeling intoxicated or unusually elevated.
How quickly might I see improvements?
Some patients may notice improvement within the first several weeks, though not every patient responds the same way.
What should I tell my healthcare provider before starting?
Share your full medication list, supplements, past depression treatments, substance-use history, and any major medical or psychiatric issues that could affect safety during treatment.
Contact Us
General Inquiries
For general questions, use this form and our team will follow up. Ready to request a consult? Please complete the consult request form.