What Spravato treats.
- Treatment-resistant depression (TRD) in adults
- Major depressive disorder with acute suicidal ideation or behavior
The mechanism.
Spravato (esketamine) is the first FDA-approved rapid-acting antidepressant that works through the NMDA receptor pathway, rather than the traditional serotonin or norepinephrine pathways targeted by older antidepressants. By modulating glutamate signaling, Spravato can produce meaningful improvements in depressive symptoms within hours to days, rather than the weeks required by oral antidepressants. It is taken in combination with an oral antidepressant.
Your Spravato infusion experience.
Spravato is self-administered as a nasal spray under the direct supervision of a healthcare provider. Because of its dissociative effects and FDA-mandated REMS protocol, you must remain at our clinic for at least 2 hours after each dose for monitoring. Treatment begins with a twice-weekly induction phase for 4 weeks, then steps down to weekly dosing, then every-other-week maintenance. You will not be able to drive after a Spravato session and must arrange transportation home.
Insurance & out-of-pocket cost.
Spravato is covered by most commercial insurance and Medicare Part B when prescribed by your physician for an FDA-approved indication. We verify your benefits before your first infusion and handle prior authorization on your behalf. Most commercially insured patients pay only their standard specialty copay — typically $20–$100 per visit. Manufacturer copay assistance programs may further reduce your cost.