Spravato Treatment Frequently Asked Questions

Answers to frequently asked questions about Spravato treatment, including how it’s administered, what side effects to expect, insurance coverage, and how it integrates with broader mental health care.

What is Spravato treatment?

Spravato treatment is an FDA-approved prescription nasal spray (esketamine) used for treatment-resistant depression and for depressive symptoms in adults with suicidal thoughts or behaviors, when clinically appropriate. It is administered in a certified medical setting under supervision.

A candidate for Spravato treatment is typically an adult diagnosed with treatment-resistant depression, often meaning symptoms have not improved after trying at least two antidepressants at adequate dose and duration. A licensed clinician must evaluate medical history, medications, and safety considerations before starting.

Spravato treatment affects glutamate activity in the brain, which differs from traditional antidepressants that primarily target serotonin, norepinephrine, or dopamine. Some patients experience symptom improvement more quickly than with standard antidepressants, though results vary.

Yes. Spravato treatment requires onsite monitoring after each dose. This observation period helps ensure safety because side effects can include sedation, dissociation, and changes in blood pressure.

No. Patients should not drive or operate machinery after Spravato treatment on the day of dosing. You’ll need a ride home and should plan for rest afterward.

Spravato treatment is not a one-time visit. It typically begins with an induction phase of more frequent sessions, followed by a maintenance phase based on clinical response. Your provider will determine the schedule and adjust it as needed.

Be cautious of clinics that do not clearly explain the required observation period, are vague about follow-up care, present Spravato treatment as a guaranteed quick fix, avoid discussing therapy or psychiatric coordination, or are not transparent about insurance and costs.

Often, yes. Many patients benefit most when Spravato treatment is integrated with psychotherapy and psychiatric care. Therapy can support long-term skill-building, relapse prevention, and treatment planning beyond symptom relief.

Yes. Spravato treatment can be integrated with Intensive Outpatient Programs (IOP) or Partial Hospitalization Programs (PHP) when clinically appropriate. For some patients, structured programs provide additional support, monitoring, and stability alongside medication-assisted treatment.

Insurance coverage varies by plan and may require prior authorization. A reputable provider should explain coverage, expected out-of-pocket costs, and any required documentation before treatment begins.

Potential side effects include dissociation, dizziness, nausea, sedation, and temporary increases in blood pressure. Because of these risks, supervised administration and post-dose monitoring are required.

A responsible provider will follow required safety protocols, explain the full process and expectations, provide consistent monitoring, coordinate care with therapy and psychiatry, discuss long-term treatment options (including IOP/PHP when needed), and be transparent about insurance and costs.