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What is Spravato?

Spravato® (esketamine intranasal) is a prescription, FDA-approved nasal spray made up of the chemical esketamine, which is made from ketamine, an anesthetic drug that is also used to treat depression at subanesthetic doses. It is administered in a healthcare clinic. When used in conjunction with an oral antidepressant, Spravato can provide relief from treatment resistant major depression and depression with suicidal thoughts, within hours of using it.

The Differences Between Spravato and Ketamine

Spravato is the only nasal spray formulation of ketamine on the market. The dose of Spravato and subanesthetic ketamine may vary. One is not necessarily better than the other. Both have a value and utility in the treatment of psychiatric illnesses.

How Spravato Treatments are Delivered

Spravato treatment varies based on an individual’s specific needs, but generally, the treatment includes giving yourself 3 doses of the nasal spray, spaced about 5 minutes apart, under medical supervision in a medical clinic.

Each treatment session lasts approximately two hours, during which patients are monitored in a comfortable, safe, and secure setting. Due to the possible side effects of the treatment, you are not permitted to drive yourself home afterwards; you must be picked up by a friend, family member, or ride share service.

Who Could Benefit from Spravato Treatments?

Spravato is for adults with treatment-resistant depression (TRD) and major depressive disorder (MDD), including those experiencing suicidal thoughts.

People Who Should Not Try Spravato

Spravato is not approved for use by children. You should not use Spravato if you are pregnant or plan to become pregnant, have a history of substance abuse, including alcoholism, blood vessel disease or a history of bleeding in the brain, uncontrolled hypertension, or other medical contraindications.

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Where to Receive Spravato Treatments

Spravato treatments are only available at certified Spravato treatment centers because the drug must be administered under the direct observation of a healthcare provider. Spravato is not for home use. LifeStance can refer you to the certified Spravato treatment center closest to you.

How Patients Describe Their Spravato Treatment Experience

Spravato can begin working right away, and some people experience improvements in symptoms within a matter of hours. This makes it an ideal treatment for individuals who are experiencing acute, debilitating symptoms or symptoms that may result in self-harm or suicidal behavior. Spravato has demonstrated efficacy in treating depression in patients with suicidal ideation, Spravato has not been shown to prevent suicide and is not a substitute for inpatient hospitalization, when needed. Though Spravato is fast acting, it is still necessary to complete a full round of treatment unless there are rare adverse effects that would require the treatment to be ended.

Are Spravato Treatments Covered by Insurance?

Spravato treatments are often covered by health insurance, and there are other resources that may be able to help with out-of-pocket medication costs for those with and without health insurance. Our office will complete a benefits investigation and estimate your out-of-pocket cost prior to treatment. You can also visit Spravato’s website to learn about the copay assistance program.

The Possible Side Effects of Spravato Treatments

Spravato may cause sleepiness, fainting, dizziness, a spinning sensation, anxiety, or feeling disconnected from yourself, your thoughts and feelings, and from space and time.

photo of LifeStance provider Dr Rachel J Dalthorp, MD
Medically Reviewed By:
Dr Rachel J Dalthorp, MD
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Dr. Dalthorp is board certified by the American Board of Psychiatry and Neurology and a Fellow of the American Psychiatric Association. She is a former member of the board of directors for the American Association of Ketamine Physicians and founding board member of the nonprofit International Society of Reproductive Psychiatry. She currently serves as Secretary and member of the Executive Council, CME, and DEI committees of the Oklahoma Psychiatric Physicians Association.