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Spravato® is a nasal spray prescribed for treatment-resistant depression. Unlike oral antidepressants, which can take several weeks to months to work, the effects of Spravato are typically felt within days, unlocking a pathway to healing for patients who have not responded to oral antidepressants and/or other augmentative therapies alone. 

Spravato is the first new drug approved for depression by the Federal Drug Administration (FDA) in decades. Spravato is specially designed for those suffering from Treatment Resistant Depression (TRD). If you are currently diagnosed with depression and have not responded well to at least two different oral antidepressants, you may qualify for Spravato treatment.

Spravato is derived from ketamine, a drug that has been used in hospitals as an anesthetic since the 1970s. Its help in alleviating symptoms of depression is a more recent discovery. Spravato nasal spray for depression is unique in that it is self-administered in an office setting under the supervision of a healthcare provider.


Standard antidepressants increase the naturally occurring chemicals in your body such as serotonin, dopamine, and norepinephrine to enhance communication between brain cells. Esketamine follows the same path but increases your glutamate levels, which are the most abundant chemical messenger in your brain. This gives you a greater impact on more brain cells at once.


Like anything else, there are potential side effects associated with treatment. Side effects will usually lessen with each treatment as your body adjusts to the Esketamine. Some things to expect include nausea, drowsiness, headaches, dizziness, feelings of intoxication, and increased blood pressure. You can read more about potential contraindications or side effects in the Medication Guide linked at the bottom of the page. Some patients also can experience more extreme side effects, including hallucinations and feeling disconnected from themselves and their surroundings. Therefore, it is vital for treatment to be done in a safe and controlled environment where the patient can be monitored.

What is the treatment schedule?

For the first four weeks, you can expect to come into the office twice weekly for treatment. During weeks 5 to 8 of treatment, you can expect to come in once weekly. For week 9 and after, the patient and their provider will decide if they should remain weekly or titrate down to biweekly.
Patients in the Spravato program should expect to be at the office for a minimum of two hours on a treatment day. You will have your blood pressure taken prior to administration, 
halfway through treatment, and then one last time at the end. Staff will monitor you throughout your treatment period. Patients will need to have a ride home from treatment and should not drive or operate heavy machinery until having a restful night’s sleep.


Spravato is given as a spray through the nose. Each device contains 1 spray for each nostril and contains a total of 28mg of Spravato. The dosing for Spravato is 56mg for the first treatment; after that, you and your provider may decide whether to continue with the 56mg dose or to increase to the 84mg.

Spravato devices

Important Safety Information

Medication Guide

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