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1. Psychiatric and benefits evaluation
Confirm diagnosis, prior treatments, current symptoms, safety, treatment goals, REMS steps, insurance, and transportation before the first dose.
Spravato care
Spravato Treatment in New York City and Long Island
Current-label esketamine care with psychiatric evaluation, benefits review, REMS requirements, monitored in-office dosing, and transportation planning.
Spravato is an esketamine nasal spray for adults with treatment-resistant depression, either as monotherapy or with an oral antidepressant. It is also indicated with an oral antidepressant for depressive symptoms in adults with major depressive disorder and acute suicidal ideation or behavior. It must be given under direct supervision in a REMS-certified setting with at least two hours of monitoring, including respiratory assessment and pulse oximetry.
Evaluation comes before treatment
The clinician confirms diagnosis, safety, treatment fit, monitoring, and follow-up before prescribing or changing medicine.
Who may be evaluated for Spravato
Eligibility depends on diagnosis, prior treatment, current symptoms, safety, treatment-day logistics, and the clinician's judgment. A booking request is not an approval for treatment.
Treatment-resistant depression
For adults with TRD, the current label allows Spravato as monotherapy or with an oral antidepressant.
Acute suicidal ideation or behavior
For depressive symptoms in adults with MDD and acute suicidal ideation or behavior, Spravato is used with an oral antidepressant; it has not been shown to prevent suicide or remove a need for hospitalization.
Safety assessment
Review blood pressure, aneurysmal vascular disease, arteriovenous malformation, intracerebral hemorrhage, respiratory risk, substance-use history, psychosis, pregnancy, and interacting medicines.
Insurance and records
Many plans require benefits verification, prior authorization, diagnosis documentation, and prior-treatment records before treatment can be scheduled.
What happens before and during a Spravato session
Each treatment session combines medication administration with required observation and discharge planning.
2. Treatment-day checks
Review medicines and symptoms, assess blood pressure, confirm food and liquid instructions, and verify a safe ride home.
3. Supervised nasal administration
The patient uses the prescribed devices under direct healthcare supervision in the certified setting.
4. At least two hours of observation
Monitor sedation, dissociation, respiratory status including pulse oximetry, blood pressure, and clinical stability before discharge.
What to prepare for the first evaluation
Complete records reduce avoidable delays and help the clinician separate a new decision from continuation of an established plan.
- Prior antidepressant names, doses, approximate dates, response, side effects, and psychotherapy or other depression-treatment history.
- Current medicines and substances, blood-pressure history, breathing conditions, vascular or neurologic history, pregnancy considerations, and allergies.
- A safe ride home and no plan to drive or operate machinery until the next day after a restful sleep.
- Insurance cards, prior authorization records, referral information, and recent psychiatric notes when available.
Safety, monitoring, and treatment boundaries
The clinical plan is individualized. These points highlight questions that need explicit review rather than replacing the current label, a full evaluation, or emergency care.
Sedation and dissociation
Spravato can cause marked sleepiness, loss of consciousness, or changes in perception and thinking. Observation continues until the patient is clinically stable.
Respiratory monitoring
Postmarketing respiratory depression and rare respiratory arrest are reflected in the current label. Each session includes at least two hours of respiratory monitoring, including pulse oximetry.
Blood-pressure increases
Blood pressure is assessed before dosing and around 40 minutes afterward, with additional monitoring when clinically warranted.
Abuse, misuse, and driving
Spravato is a Schedule III controlled substance. The team assesses misuse risk, and the patient must not drive until the next day after restful sleep.
When to get urgent or emergency help
Call 911 for immediate danger, a suicide attempt, severe trouble breathing, loss of consciousness, or severe neurologic or cardiovascular symptoms. Call or text 988 for suicidal thoughts or a mental health crisis. Spravato does not replace hospitalization when it is clinically needed.
Established Spravato location access
Nao lists these eight Spravato program locations. Book first so the team can confirm the clinic's current REMS readiness, staffing, observation capacity, insurance workflow, transportation plan, and appointment availability.
Queens
Astoria
37-15 23rd Ave, Astoria, NY 11105
Book first so the Spravato team can confirm current program capacity, REMS requirements, coverage, transportation, observation, and appointment timing before you travel.
Bronx
Bartow Mall
2063A Bartow Ave, Bronx, NY 10475
Book first so the Spravato team can confirm current program capacity, REMS requirements, coverage, transportation, observation, and appointment timing before you travel.
Long Island
Hicksville
232 W Old Country Rd, Hicksville, NY 11801
Book first so the Spravato team can confirm current program capacity, REMS requirements, coverage, transportation, observation, and appointment timing before you travel.
Queens
Jamaica
90-18 Sutphin Blvd, Jamaica, NY 11435
Book first so the Spravato team can confirm current program capacity, REMS requirements, coverage, transportation, observation, and appointment timing before you travel.
Queens
Long Island City
30-07 36th Ave, Astoria, NY 11106
Book first so the Spravato team can confirm current program capacity, REMS requirements, coverage, transportation, observation, and appointment timing before you travel.
Long Island
Mineola
135 Mineola Blvd, Mineola, NY 11501
Book first so the Spravato team can confirm current program capacity, REMS requirements, coverage, transportation, observation, and appointment timing before you travel.
Manhattan
StuyTown
259 1st Ave, New York, NY 10003
Book first so the Spravato team can confirm current program capacity, REMS requirements, coverage, transportation, observation, and appointment timing before you travel.
Brooklyn
Williamsburg
308 Graham Ave, Brooklyn, NY 11211
Book first so the Spravato team can confirm current program capacity, REMS requirements, coverage, transportation, observation, and appointment timing before you travel.
Related psychiatric care
Choose condition-focused care for diagnosis and long-term treatment planning. Choose a medicine-specific service for initiation, access, monitoring, delivery, or administration questions.
Treatment-resistant depression management
Review diagnosis, adequate prior trials, bipolar screening, and the full advanced-care decision.
Spravato eligibility
Prepare treatment records and safety information before a product-specific decision.
Spravato insurance review
Understand benefits verification, prior authorization, and plan-specific documentation.
Treatment-day transportation
Plan the required ride home and next-day driving restriction.
What happens during treatment
Review supervised dosing, observation, blood pressure, and discharge planning.
Psychiatric medication management
Coordinate Spravato with the broader depression medication plan and follow-up.
Clinical and regulatory sources
These authoritative sources were checked on August 1, 2026. Drug labels and guidance can change, so the treating clinician uses current information for each decision.
NIH DailyMed / FDA-approved labeling
Spravato prescribing information
Current indications, REMS, blood pressure, respiratory monitoring, observation, and driving restriction.
Open official sourceSpravato REMS
Spravato REMS
Certified-setting, patient enrollment, supervised treatment, and REMS requirements.
Open official sourceU.S. Department of Veterans Affairs and Department of Defense
VA/DoD Clinical Practice Guideline for Major Depressive Disorder
Initial assessment, treatment selection, inadequate response, and advanced care management.
Open official sourceU.S. Food and Drug Administration
MedWatch safety information and adverse-event reporting
How patients and clinicians can report suspected medication problems.
Open official sourceCommon questions about Spravato treatment
Yes. The current March 2026 prescribing information indicates Spravato for treatment-resistant depression in adults as monotherapy or with an oral antidepressant.
The label states that effectiveness in preventing suicide or reducing suicidal ideation or behavior has not been demonstrated. Spravato does not remove the need for hospitalization when clinically warranted.
Patients are observed for at least two hours and remain until the healthcare team determines they are clinically stable and safe to leave.
The current label calls for monitoring respiratory status for at least two hours, including pulse oximetry, during each treatment session.
No. Arrange safe transportation home. Do not drive or operate machinery until the next day after a restful sleep.
Because nausea and vomiting can occur, the label advises avoiding food for at least two hours and liquids for at least 30 minutes before administration. Follow the clinic's final instructions.
Coverage varies by plan, diagnosis, prior treatments, benefit rules, prior authorization, and treatment site. Nao can coordinate a benefits review, but approval and cost are not guaranteed.
Contact the treatment team. The label says patients without worsening symptoms may continue the current schedule; worsening during maintenance can lead the clinician to consider a prior, more frequent schedule.
Updated August 1, 2026. This information does not replace an individual medical evaluation. A licensed clinician determines diagnosis, medication eligibility, prescribing, testing, dosing, administration, and follow-up.
Health information notice
General information only. This page is not medical advice and does not replace diagnosis, treatment, or guidance from a licensed clinician.
Content was updated August 1, 2026 from the sources cited on this page. Medical guidance, prescribing information, medication availability, and insurance rules can change. A licensed clinician must confirm current information and determine each patient's eligibility, testing, treatment, administration setting, and follow-up. Call 911 for a medical emergency. Contact Nao Medical with a question or correction.