Spravato is the brand name for esketamine nasal spray, an FDA-approved prescription treatment used for certain adults with depression. It is most commonly used for adults with treatment-resistant depression, meaning depression that has not improved enough after trying other antidepressant treatments. Spravato is given in a certified medical setting under supervision as part of a structured treatment plan.
Spravato works differently from standard antidepressants. While many traditional antidepressants mainly affect serotonin, Spravato acts on NMDA receptors in the brain and influences the glutamate system, which plays a role in mood, learning, and neural connectivity. This different mechanism is one reason it may help some patients who have not responded well to standard antidepressants.
Yes. Spravato is FDA-approved for eligible adults with treatment-resistant depression and for certain adults with major depressive disorder with acute suicidal thoughts or actions when clinically appropriate. It must be administered in a certified healthcare setting that follows the REMS program and FDA safety requirements.
Spravato can be safe when it is used appropriately in a certified medical setting under trained supervision. Because it can cause temporary side effects such as sedation, dissociation, and increased blood pressure, patients are monitored after each treatment. Safety protocols are built into the treatment process, including in-office observation and clear guidance about what patients should and should not do after a session.
The most common Spravato side effects may include dizziness, dissociation, nausea, sleepiness, feeling disconnected, vertigo, anxiety, and temporary increases in blood pressure. Some people also feel tired or less alert after treatment. These effects are usually monitored in the office and often improve as the treatment session passes. Your provider will review possible side effects with you before starting treatment.
Yes. Spravato is an outpatient treatment. It is given in-office in a certified medical setting, and patients go home the same day after the required monitoring period. A hospital stay is not usually needed.
Each Spravato session usually takes about two hours or a little longer from start to finish. This includes the time for administration and the required observation period afterward. Patients should plan for the full visit and avoid trying to rush back to normal activities immediately after treatment.
After Spravato treatment, you stay in the office for monitoring while the clinical team observes your recovery and checks on your safety. Once you are cleared to leave, you go home the same day. You should not drive yourself after treatment, so you will need transportation arranged in advance. Follow-up visits are scheduled based on your treatment plan.
The number of sessions varies by patient, symptoms, and how well treatment is working. Many patients begin with an initial phase that involves more frequent visits, followed by a maintenance phase with less frequent sessions. Your provider will tailor the plan to your progress and your clinical needs.
The Spravato dosing schedule usually starts with an induction phase, often involving twice-weekly treatment for the first few weeks, followed by a maintenance phase where treatment becomes less frequent. The exact schedule depends on your diagnosis, how you respond, and your provider's clinical judgment. Some patients continue weekly treatment for a period, while others may space treatments farther apart over time.
Spravato may be appropriate for adults with treatment-resistant depression or certain adults with major depressive disorder in specific clinical circumstances. In general, patients being evaluated for treatment-resistant depression have usually tried at least two antidepressants without enough relief. Qualification depends on diagnosis, medication history, symptoms, safety considerations, and overall clinical evaluation.
Many insurance plans do cover Spravato. Nao Medical works with commercial insurance, Medicare, Medicaid, and New York State Medicaid Managed Care plans, but coverage still depends on your plan benefits, diagnosis, and prior authorization requirements. A benefits check is usually completed before treatment begins so you can understand expected coverage and out-of-pocket cost.
Yes. Nao Medical accepts Medicaid for Spravato treatment in New York, including New York State Medicaid Managed Care plans such as Healthfirst, Fidelis Care, and UnitedHealthcare Community Plan, subject to eligibility, benefits verification, and prior authorization requirements.
Yes, Spravato often requires prior authorization. Insurance companies commonly ask for documentation showing the diagnosis, previous antidepressant trials, and medical necessity. The approval process can vary by plan, but eligible Nao Medical patients are assigned a care manager who can help gather records, submit paperwork, track status, and keep treatment moving.
Yes. Eligible patients are assigned a dedicated care manager who can act as a single point of contact for benefits verification, prior authorization questions, scheduling updates, first-visit preparation, and transportation coordination for treatment days.
Yes. Patients should plan safe transportation home after each Spravato treatment and should not drive or use heavy machinery until the next day after a restful sleep. If transportation is a barrier, our team can help coordinate the logistics before your session.
Plan a ride home, review your medications with the care team, and expect to stay in the office for at least 2 hours of monitoring after dosing. Patients are generally advised not to eat for at least 2 hours before treatment or drink liquids for at least 30 minutes before treatment. If you use a nasal corticosteroid or nasal decongestant, your clinician may ask you to take it at least 1 hour before Spravato.
Spravato and ketamine are related, but they are not the same. Spravato is the brand name for esketamine nasal spray, which is FDA-approved and administered under a REMS-certified process in a medical office. Ketamine treatment is often used off-label and may be offered in other forms, such as IV infusion, depending on the practice. Patients comparing Spravato vs ketamine usually want to understand differences in approval status, treatment setting, monitoring, and insurance coverage.
Spravato and TMS are both advanced treatment options for people with difficult-to-treat depression, but they work very differently. Spravato is a medication-based treatment using esketamine nasal spray in a supervised medical setting. TMS is a non-drug treatment that uses magnetic stimulation to target specific brain regions. They differ in mechanism, treatment schedule, side effects, and patient experience. The best choice depends on the patient's symptoms, treatment history, preferences, and clinical evaluation.
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