SPRAVATO® (Esketamine)
New hope for treatment-resistant depression.
When antidepressants haven't worked, SPRAVATO® offers a clinically proven alternative — a nasal spray treatment that can reduce symptoms rapidly, often within hours of the first session.
A different kind of antidepressant
SPRAVATO® (esketamine) is an FDA-approved nasal spray for adults with treatment-resistant depression (TRD) — meaning depression that has not adequately responded to at least two different antidepressant medications.
Unlike traditional antidepressants which work on serotonin, esketamine works on the glutamate system — a completely different pathway in the brain. This is why it can work rapidly for patients who have not responded to other treatments.
It is always used alongside an oral antidepressant and must be administered in our clinic under medical supervision, as part of the REMS (Risk Evaluation and Mitigation Strategy) programme.
Who is it for?
- Adults with depression that has not responded to 2+ antidepressants
- Major depressive disorder with acute suicidal ideation (urgent treatment)
- Those experiencing persistent hopelessness, anhedonia, or functional impairment
- Patients seeking a faster-acting alternative to traditional antidepressants
SPRAVATO® received FDA approval in 2019 for treatment-resistant depression and in 2020 for MDD with suicidal ideation. It has been evaluated in multiple Phase III clinical trials.
What a SPRAVATO® course looks like
- 1InductionWeeks 1–4Twice weekly (8 sessions)
- 2Maintenance IWeeks 5–8Once weekly (4 sessions)
- 3Maintenance IIWeek 9+Every 1–2 weeks (ongoing)
Each session lasts about 40 minutes. You stay for 2 hours of observation before you can leave.
You cannot drive after a session. A friend, family member, or rideshare is required for every visit.
SPRAVATO® is always used alongside an oral antidepressant as part of a complete treatment plan.
Common questions about SPRAVATO®
SPRAVATO® is FDA-approved for adults with treatment-resistant depression (at least two prior antidepressants that didn't work adequately) or major depressive disorder with acute suicidal ideation. A full psychiatric evaluation is required to determine if it's right for you.
During the session you may experience temporary dissociation, dizziness, or a mild altered sense of perception. These effects are normal, temporary, and carefully monitored by our clinical staff. Most patients feel back to baseline within the 2-hour observation window.
The standard induction phase is two sessions per week for four weeks (8 sessions). After that, the schedule moves to once weekly, then once every two weeks based on your response. Your psychiatrist will tailor the plan to you.
No. You must arrange a ride home after every SPRAVATO® session and avoid driving or operating machinery for the rest of that day. We recommend having a trusted person pick you up.
Many major insurers, including Medicare, cover SPRAVATO® for eligible patients. Prior authorisation is typically required. Our billing team will handle the insurance verification and authorisation process with you.
Unlike traditional antidepressants that can take 4–6 weeks to show effect, many patients notice an improvement in depressive symptoms within hours to days of their first few sessions. Results vary by individual.
Take the next step
Toward feeling better.
Our team will evaluate whether SPRAVATO® is right for you and walk you through the entire process — insurance, scheduling, and what to expect.
If you didn't find what you were looking for, reach out at info@healinghorizons.us — we're here for you.