What to Expect: Spravato Treatment

Ketamine is a medication originally developed as an anesthetic and pain-relieving drug, used safely in hospitals and medical settings for decades. In low doses, it has been shown to rapidly reduce symptoms of depression, anxiety, and suicidal thoughts by acting on a unique system in the brain called the glutamate pathway rather than the serotonin system targeted by traditional antidepressants.

Esketamine is a refined, more targeted version of ketamine that specifically activates receptors associated with antidepressant effects while minimizing unwanted dissociative or anesthetic side effects. It is the active ingredient in Spravato, an FDA-approved medication for treatment-resistant depression and depression with suicidal thoughts.

Unlike traditional antidepressants that target serotonin, Esketamine blocks NMDA receptors in the brain to regulate glutamate. This action stimulates AMPA receptors and promotes the growth of new neural connections, which helps ‘reset’ communication between brain cells and improves mood regulation often within hours or days.

In most cases, yes. Spravato is prescribed alongside a standard oral antidepressant, and most patients continue their other maintenance medications. However, you should disclose every medication you are taking to ensure safety, as certain sedatives or blood pressure medications may require a review.

No. Spravato is an FDA-approved, prescription-only medication administered only in a controlled clinical setting under direct medical supervision. It cannot be taken home. Recreational ketamine is unregulated and frequently misused, whereas Spravato is monitored through the FDA’s strict REMS safety program.

Yes. Spravato is FDA-approved and administered only in certified treatment centers like Strive CLE Counseling. Vital signs and mental status are closely monitored during each session by trained clinical staff to ensure safety and comfort.

Spravato is designed and administered in a controlled medical environment to minimize risk. According to the FDA and clinical data, it carries a low potential for abuse because it is never dispensed for home use. Long-term safety studies found no evidence of physical dependence among patients.

While both act on the glutamate system, ketamine infusions are administered intravenously and used ‘off-label.’ Spravato is FDA-approved specifically for depression and delivered as a nasal spray, providing more predictable dosing and broader insurance coverage.

Spravato has been extensively studied for depression that does not respond to standard antidepressants. Clinical trials show that it can reduce relapse risk by 51% and provide symptom relief as quickly as 24 hours after the first dose for some patients.

Most major insurance carriers, including Medicaid and commercial plans, cover Spravato when prior authorization criteria are met. Our administrative team verifies your benefits and assists with the Spravato withME cost savings program to lower out-of-pocket costs.

Spravato is self-administered via a nasal spray in a comfortable, private clinical space. You will take the medication yourself in three doses spaced several minutes apart, followed by a relaxation and observation period lasting at least two hours.

Common side effects include dizziness, feeling ‘spacey,’ sedation, nausea, and mild increases in blood pressure. These usually occur shortly after administration and resolve before you leave the office. Clinical staff monitor your comfort and vitals throughout the session.

The protocol begins with an induction phase of twice-weekly sessions for the first four weeks. This is followed by once-weekly sessions for several weeks, then a maintenance phase—typically once every two weeks—tailored to your individual response.

Spravato is designed for adults who have not had sufficient improvement from at least two other antidepressants, or those experiencing major depressive episodes that haven’t responded to oral medication alone.

You may feel relaxed or drowsy for several hours. You must arrange for transportation home and avoid driving or operating machinery for 24 hours after treatment. Resting and hydrating are highly recommended.

We offer an integrative approach that combines medical supervision under psychiatric providers with trauma-informed therapy. Our setting is designed for safety and comfort, providing on-site therapeutic support and mindfulness-based integration during your recovery.