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Spravato is the brand name for esketamine nasal spray. Its current US label covers treatment-resistant depression in adults, either on its own or with an oral antidepressant.
The current Spravato label permits treatment-resistant depression in adults either alone or with an oral antidepressant. A separate indication covers depressive symptoms in adult major depressive disorder with acute suicidal thoughts or behaviour, and that use requires an oral antidepressant. Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behaviour. It does not replace hospitalization when needed. Treatment involves supervised nasal dosing in a REMS-certified setting, medical monitoring and continuing psychiatric review, not an unsupervised home spray.
Spravato is the brand name for esketamine nasal spray. Its current US label covers treatment-resistant depression in adults, either on its own or with an oral antidepressant. A separate indication covers depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behaviour; that use requires an oral antidepressant. Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behaviour, and it does not replace hospitalization when that is needed.
Esketamine affects NMDA receptors in the brain. Its antidepressant mechanism is not fully understood. It differs from standard oral antidepressants and from IV ketamine. Feeling dissociated during a session is not a test of whether the depression treatment will work. The clinician judges benefit from symptoms, daily function and safety over time.
Assessment reviews the diagnosis, previous treatments and whether they were taken at an adequate dose and duration. The clinician checks blood pressure, cardiovascular and cerebrovascular history, psychosis, substance-use risks, pregnancy and interacting medicines. Aneurysmal vascular disease, arteriovenous malformation, a history of intracerebral hemorrhage and hypersensitivity are labelled contraindications. Insurer criteria can differ from the clinical label.
Bring antidepressant names, doses, dates, response, adverse effects and relevant hospital records. Clarify whether the proposed treatment is TRD care or the separate acute suicidal MDD indication. Discuss other suitable treatments and continuing therapy.
Spravato is administered through its REMS in a certified healthcare setting. Patients self-administer the nasal spray under direct supervision. Blood pressure is checked before dosing, around 40 minutes afterwards and further as needed. Breathing is monitored, including pulse oximetry, for at least two hours. Release occurs only when the clinician finds the patient stable. Some visits take longer.
TRD treatment is twice weekly for the first four weeks, then weekly in weeks five through eight. From week nine, dosing is weekly or every two weeks according to response. The clinician assesses benefit after the initial four weeks. The acute suicidal MDD regimen is a separate twice-weekly four-week course. Longer use for that indication has not been systematically evaluated.
Arrange transport home and leave time for the observation period. Do not eat for at least two hours before a dose or drink liquids for at least 30 minutes before it. If using a nasal corticosteroid or decongestant, follow the label’s timing of at least one hour before Spravato. Bring the medicine list and report alcohol, sedatives, opioids or new symptoms. Do not change other medicines without instructions.
The boxed warning covers sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviours associated with antidepressants in younger people. Do not drive, operate machinery or undertake activities requiring full alertness until the next day after a restful sleep. Arrange a ride home even if you feel ready to drive. Blood-pressure elevation can make a session unsuitable. Spravato may harm the fetus during pregnancy and breastfeeding is not recommended during treatment. Urgent worsening depression or a suicide crisis needs immediate clinical or emergency care rather than waiting for the next session.
Track depression symptoms, daily function, adverse effects and missed sessions with the treating team. A late session is not a reason to double a dose. If maintenance sessions are missed and symptoms worsen, the clinician may consider returning to a previous frequency. Continuing care includes psychiatric review and safety planning, not just attendance at nasal-spray visits.
Ask for separate confirmation of medication coverage, administration and monitoring charges, authorization dates and the number of approved visits. A previous approval does not guarantee a new dose, renewal or paid claim. Ask about appeals and documentation if denied. Confirm the selected site’s REMS status, appointment capacity and transport policy directly. Ask whether the medicine is ready and which charges are approved.
Spravato is the brand name for esketamine nasal spray. Its current US label covers treatment-resistant depression in adults, either on its own or with an oral antidepressant. A separate indication covers depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behaviour; that use requires an oral antidepressant. These indications should not be merged into one promise. Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behaviour, and it does not replace hospitalization when that is needed.
Assessment reviews the diagnosis, previous treatments and whether they were taken at an adequate dose and duration. The clinician checks blood pressure, cardiovascular and cerebrovascular history, psychosis, substance-use risks, pregnancy and interacting medicines. Aneurysmal vascular disease, arteriovenous malformation, a history of intracerebral hemorrhage and hypersensitivity are labelled contraindications. Insurer criteria can differ from the clinical label.
Spravato is the brand name for esketamine nasal spray. Its current US label covers treatment-resistant depression in adults, either on its own or with an oral antidepressant. A separate indication covers depressive symptoms in adults with major depressive disorder who have acute suicidal thoughts or behaviour; that use requires an oral antidepressant. These indications should not be merged into one promise. Spravato has not been shown to prevent suicide or reduce suicidal thoughts or behaviour, and it does not replace hospitalization when that is needed.
Assessment reviews the diagnosis, previous treatments and whether they were taken at an adequate dose and duration. The clinician checks blood pressure, cardiovascular and cerebrovascular history, psychosis, substance-use risks, pregnancy and interacting medicines. Aneurysmal vascular disease, arteriovenous malformation, a history of intracerebral hemorrhage and hypersensitivity are labelled contraindications. Insurer criteria can differ from the clinical label.
Esketamine affects NMDA receptors in the brain. Its antidepressant mechanism is not fully understood. It differs from standard oral antidepressants and from IV ketamine. Feeling dissociated during a session is not a test of whether the depression treatment will work. The clinician judges benefit from symptoms, daily function and safety over time.
The boxed warning covers sedation, dissociation, respiratory depression, abuse and misuse, and suicidal thoughts and behaviours associated with antidepressants in younger people. Do not drive, operate machinery or undertake activities requiring full alertness until the next day after a restful sleep. Arrange a ride home even if you feel ready to drive. Blood-pressure elevation can make a session unsuitable. Pregnancy may harm the fetus and breastfeeding is not recommended during treatment. Urgent worsening depression or a suicide crisis needs immediate clinical or emergency care rather than waiting for the next session.
Common Spravato effects include dissociation, dizziness, nausea, sleepiness, vertigo, vomiting, numbness and a rise in blood pressure. Tell the supervising team about troubling effects during the session. Breathing difficulty, severe headache, chest pain, fainting, neurological symptoms or dangerous worsening mood need immediate assessment. Observation lasts at least two hours and until clinically stable; feeling better does not remove the next-day-after-rest driving restriction.
Have your insurance card ready when booking. Share member details through the clinic’s confirmed secure intake process. Check with the clinic and your insurer that the exact plan covers the clinician and requested service. Ask about visit charges, any separately billed tests or medicines, and any referral or authorization requirement. Coverage and your copay or deductible depend on the plan; request a written estimate if paying yourself.
The phrase often refers to ketamine or esketamine, which affect glutamate signaling. It does not identify a single approved care program. Spravato is nasal esketamine with specific adult depression indications and supervised REMS visits. IV ketamine psychiatric use is off-label. Ask which product, indication, setting and monitoring the clinician proposes; the phrase does not establish availability or suitability.
At Nao Medical, we offer esketamine treatment in New York for adults who may be living with treatment-resistant depression, depression not responding to medication, or depression after failed antidepressants. Esketamine is a modern, evidence-based treatment option that works differently from standard antidepressants and may help some patients who need the next step in care.
SPRAVATO is FDA-approved esketamine nasal spray for specified adult depression indications. If depression has not improved after adequate treatment attempts, a clinician can review whether treatment-resistant depression care, including SPRAVATO, is appropriate. Related information: treatment-resistant depression.
Many patients ask about Spravato therapy vs esketamine therapy. In most practical discussions, they refer to the same treatment. Spravato is the brand name, and esketamine is the medication itself.
Yes. Esketamine is commonly considered for adults who have gone through multiple antidepressant trials without enough improvement. That is why it is closely associated with failed antidepressants, depression not responding to medication, and treatment-resistant depression.
Nao Medical offers supervised esketamine treatment in New York for adults seeking a more advanced, evidence-based path forward. Schedule a consultation to learn whether esketamine may be the right next step for your care.
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