How long does Spravato take to work?

Spravato enhances activity in the regions of the brain that are responsible for mood regulation, which are often underactive in depression. Spravato’s effects can occur within hours, often within 24 hours, leading to symptom relief and an improved mood (compared to traditional antidepressants that may take weeks or months to provide relief).

What is the success rate of Spravato?

Clinical studies have shown that between 50% to 70% of individuals with treatment-resistant depression experience noticeable relief from depression symptoms after taking Spravato.

How often do I do Spravato?

Spravato is administered twice a week for four weeks.

Then Spravato is administered once a week for four weeks.

After that, depending on your progress, you can do Spravato once a week or once every other week until you and our provider feel you have achieved the desired results.

Treatment beyond that varies based on individual needs, but many patients continue for several months to ensure long-term effectiveness and symptom relief.

What should I expect from my Spravato treatment?

After arriving in our office and getting settled comfortably in our Spravato treatment room, you will administer the nasal spray and then relax while we monitor your progress. You must stay in our office for two hours. You cannot drive home, so you must have a ride or order rideshare transportation home.

What are the potential side effects?

While in our office, Spravato may cause a brief period of dissociation (feeling spacey, drunk, or euphoric), it can make you sleepy, and some patients may also experience nausea or dizziness. We monitor you closely during this time to ensure your comfort and safety and make sure these side effects have worn off before you leave our office. However, you may feel sleepy for the remainder of the day, so you may not drive and may want to ensure your schedule is clear so you can rest.

How long does Spravato last?

The longevity of the effects from Spravato differs from person to person. Studies show that some patients may need up to six months of treatment to achieve the desired results. We also offer TMS, which may also be recommended to ensure longer-term results and assist with durability.

How is Spravato different from oral antidepressants?

Traditional antidepressants increase levels of serotonin, norepinephrine, and dopamine. Spravato targets NMDA receptors in the brain that can help rewire how you process emotions and increase neurotransmitters, which creates better communication between brain cells and positively affects mood.

I have had addiction issues in the past. Can I do Spravato?

You will be encouraged to honestly share your medical and substance use history with our Spravato Coordinator during your initial evaluation. Spravato is a psychoactive substance with a potential for misuse and abuse. We will need to determine if Spravato is appropriate for you based on your past (or current) substance use.

Can I do Spravato and TMS at the same time?

We will assess your situation to see if Spravato or TMS is the most appropriate treatment for you. If you are acutely suicidal, we may start Spravato first to give you immediate relief and to stabilize you before beginning TMS. Spravato may also be done after TMS if you are still feeling symptoms of depression and want to see if you can feel even better. If patients are not responding to either Spravato or TMS, we may try a dual approach and do them both at the same time to provide relief.

What disqualifies me from doing Spravato?

You cannot take Spravato if you have:

• an aneurysm
• an abnormal connection between your blood vessels (arteriovenous malformation)
• a history of bleeding in the brain (intracerebral hemorrhage)
• or if you are allergic to esketamine, ketamine, or any of the ingredients in Spravato.

You must be honest in your evaluation with our Spravato Coordinator about your medical history so we can ensure Spravato is safe for you.

What insurances do you take?

We take almost every commercial insurance for Spravato; however, we do not accept Medicare for Spravato treatment.

Is Spravato a psychedelic?

Spravato is not classified as a psychedelic but is psychoactive.

How are Spravato and Ketamine different?

Spravato (esketamine) and ketamine are similar; however, ketamine is not approved by the FDA to treat depression and is not covered by insurance.

What about TMS with Spravato?

There is evidence that suggests that combining TMS and Spravato can be more effective for treatment-resistant depression than either treatment alone, potentially leading to faster symptom relief and higher remission rates. Appropriateness for receiving both treatments simultaneously will be made on a case-by-case basis by our clinical providers and may depend on insurance coverage.