A New Option for Treatment-Resistant Depression and  Severe Depressive Symptoms

Core Psychiatry offers Spravato® treatments at our practice.  Spravato® an FDA-approved treatment option for adults with:

• Treatment-Resistant Depression (TRD): For those who have tried multiple antidepressant medications but continue to experience significant depressive symptoms.

• Major Depressive Disorder (MDD) with Suicidal Thoughts or Actions: For adults experiencing a severe depressive episode that includes acute suicidal ideation or behavior.

Spravato® may be considered for patients who have tried antidepressant medications but continue to experience significant depressive symptoms.

Spravato® works differently than traditional antidepressants and is administered in a certified healthcare setting under medical supervision. Patients are monitored for at least two hours after each treatment for safety.

What Is Spravato®?

Spravato® is a prescription nasal spray containing esketamine approved for adults. Depending on your specific diagnosis and the treatment plan determined by your provider, it is used:

• With or without an oral antidepressant to treat Treatment-Resistant Depression (TRD).

• Always in conjunction with an oral antidepressant to treat depressive symptoms in adults with MDD experiencing acute suicidal thoughts or actions

Why Consider Spravato®?

For many individuals living with depression, traditional antidepressants can be life-changing. However, some people continue to experience significant symptoms despite trying multiple medications, therapy, and other treatments. If this sounds familiar, Spravato® may offer a new path toward recovery.

Spravato® Works Differently Than Traditional Antidepressants

Most antidepressants work by affecting neurotransmitters such as serotonin, norepinephrine, or dopamine. Spravato works through a different pathway in the brain involving glutamate, which is believed to play an important role in mood regulation, learning, and neural connections. This novel mechanism of action may help patients who have not responded adequately to conventional treatments.

Potential Benefits of Spravato® Treatment

Faster Relief of Symptoms

Traditional antidepressants may take several weeks before patients notice improvement. Some patients receiving Spravato experience improvement in depressive symptoms much more quickly, with some studies demonstrating benefits within the first 24 hours to several days after treatment.

An Option When Other Treatments Have Failed

Spravato® was specifically developed for adults with treatment-resistant depression, meaning depression that has not adequately improved after trying multiple antidepressant medications. For many patients, Spravato® offers a treatment option when previous medications have provided little or no relief.

May Help Reduce the Severity of Depression

Clinical studies have shown that Spravato can significantly reduce depressive symptoms in many patients with treatment-resistant depression. Some patients experience meaningful improvements in mood, energy, motivation, concentration, and overall functioning.

A Different Approach to Brain Healing

Researchers believe Spravato may help promote new connections between brain cells that can be disrupted by chronic depression. While research continues, this unique mechanism represents one of the most important advances in depression treatment in decades.

Convenient In-Office Treatment

Unlike IV ketamine infusions, Spravato® is an FDA-approved nasal spray administered in a comfortable medical setting under the supervision of trained healthcare professionals. Patients receive treatment in a safe, supportive environment while being monitored throughout the visit.

Could Spravato® Be Right for You?

You may want to discuss Spravato treatment with your provider if you:

• Have tried two or more antidepressants without sufficient improvement.

• Continue to struggle with depression despite therapy and medication.

• Feel that your depression is interfering with work, relationships, or daily activities.

• Are looking for an evidence-based treatment option that works differently than traditional antidepressants.

• Want to explore innovative treatments that may provide relief when other approaches have not been successful.

Spravato® is not right for everyone. Before starting treatment, our team will complete a thorough evaluation, review your medical and psychiatric history, discuss current medications, and determine whether Spravato® is a safe and appropriate option.

What to Expect During Treatment

Each Spravato® visit takes place in our office. During your treatment session:

1. We will check in with you and review how you are feeling.

2. You will self-administer Spravato® nasal spray under supervision.

3. You will relax in a comfortable treatment space while our team monitors you.

4. Your blood pressure, alertness, and overall response will be checked.

5. You will remain in the clinic for at least two hours before leaving.

Because Spravato® can cause sleepiness, dissociation, dizziness, and changes in blood pressure, patients cannot drive or operate machinery until the next day after a restful night of sleep.

Safety and Monitoring

Spravato® is available only through a Risk Evaluation and Mitigation Strategy, known as the Spravato® REMS Program. This program requires treatment to take place in Core Psychiatry's certified healthcare setting and requires monitoring after each dose.

Our goal is to provide a calm, supportive, and medically supervised environment where patients can receive treatment safely and comfortably.

⚠️ Important Safety Information for Acute Symptoms

Please note that while Spravato® can provide rapid relief from severe depressive symptoms, its effectiveness in preventing suicide or in reducing suicidal thoughts or behavior has not been definitively demonstrated on its own. The use of Spravato® does not replace the need for emergency psychiatric care or hospitalization if a patient is in immediate danger.

Getting Started

If you or a loved one has been struggling with depression despite trying medication, Spravato may be an option worth exploring.

To learn more or schedule a consultation, contact Core Psychiatry. Our team will help determine whether Spravato is appropriate for your needs and walk you through each step of the process.

Is Spravato® the same as ketamine?

No. Spravato® contains esketamine, a component of ketamine, but it is not the same as IV ketamine or compounded ketamine treatments. Spravato® is the first and only FDA-approved nasal spray specifically approved for adults with treatment-resistant depression and is administered under medical supervision in our certified healthcare setting.

Who is a candidate for Spravato®?

Spravato® may be an option for adults who have been diagnosed with Treatment-Resistant Depression (meaning they have tried at least two antidepressant medications without achieving adequate improvement) or those experiencing Major Depressive Disorder accompanied by acute suicidal thoughts or actions. A comprehensive psychiatric evaluation is required to determine whether Spravato® is a safe and appropriate treatment path for you.  

How does Spravato® work?

Unlike traditional antidepressants that primarily target serotonin, norepinephrine, or dopamine, Spravato® works through the brain's glutamate system. This unique mechanism may help restore neural connections affected by depression and can provide relief for some patients who have not responded to conventional treatments.

How quickly does Spravato® work?

Traditional oral antidepressants often take several weeks before patients notice a significant change. Some patients receiving Spravato® report an improvement in symptoms within the first few days of beginning treatment, though individual responses vary. Because the medication works incrementally, your provider will evaluate your overall response across the initial 4-week induction phase to determine how well Spravato® is working for you. 

What does a Spravato® treatment feel like?

Every patient's experience is different. During treatment, some patients report feeling relaxed, sleepy, detached from their surroundings, or experiencing changes in perception or awareness. These effects typically peak within the first hour and generally resolve during the observation period. Our team closely monitors patients throughout the entire treatment session to ensure comfort and safety.

How long does each appointment take?

Plan to spend approximately 2.5 to 3 hours in our office for each treatment session. This includes check-in, administration of the medication, and the required monitoring period following treatment. Federal safety regulations require that all patients be observed for at least two hours after receiving Spravato.

How many treatments will I need?

Spravato® treatment schedules depend on your specific diagnosis:

For Treatment-Resistant Depression: Treatment occurs in phases. Weeks 1–4 involve two treatments per week; Weeks 5–8 drop to once per week; and maintenance sessions typically continue every one to two weeks based on your provider's recommendation.

For Depressive Symptoms with Acute Suicidal Thoughts: Treatment is typically an intensive 4-week course consisting of two treatments per week, paired alongside an oral antidepressant. Further treatment past 4 weeks is evaluated individually by your provider.

Treatment plans are individualized based on each patient's symptoms and progress.

Can I drive myself home after treatment?

No. Because Spravato® can temporarily affect alertness, coordination, and perception, patients should not drive or operate machinery until the day after treatment following a restful night's sleep. You will need to arrange transportation home after each appointment.

Will insurance cover Spravato®?

Many commercial insurance plans, Medicare, and some Medicaid plans provide coverage for Spravato® when medical criteria are met. Coverage requirements vary by insurance carrier and often require prior authorization. Our team will work with you to verify benefits and help navigate the approval process whenever possible.

Helpful Information

• Official SPRAVATO® Website 

• SPRAVATO® Insurance Coverage and Patient Support 

• Learn More About How SPRAVATO® Works