SPRAVATO (esketamine) is a FDA-approved nasal spray treatment for treatment-resistant depression. Administered in a safe, supervised clinical setting.

SPAVATO works differently than traditional antidepressants, often providing faster symptom relief for individuals struggling with severe depression or suicidal thoughts.

What Is SPRAVATO®?

SPRAVATO® (esketamine) is a prescription nasal spray approved by the FDA for use in combination with an oral antidepressant in certain adults with major depressive disorder.

Unlike traditional antidepressants, SPRAVATO® acts on the brain’s glutamate system. Due to specific safety risks, SPRAVATO® is only available through the SPRAVATO® Risk Evaluation and Mitigation Strategy (REMS) Program and cannot be taken at home.

Prescribed For

SPRAVATO® may be considered for adults diagnosed with:

  • Treatment-Resistant Depression (TRD)
    (Depression that has not adequately responded to at least two antidepressant medications)

  • Major Depressive Disorder (MDD) with Acute Suicidal Ideation or Behavior
    Used alongside an oral antidepressant and broader mental health support

SPRAVATO® has not been shown to prevent suicide or reduce suicidal behavior on its own. Ongoing treatment, monitoring, and safety planning remain essential.

Determining Eligibility

SPRAVATO® is not appropriate for everyone. Eligibility is determined through a clinical evaluation that may include:

  • Review of psychiatric history and previous treatments

  • Medical history and current medications

  • Blood pressure assessment and other safety considerations

  • Coordination with your prescribing provider or referral source

Final determination is made by a qualified medical professional.

What to Expect During SPRAVATO® Treatment

SPRAVATO® treatment at Braden Counseling follows federally required safety protocols:

  • In-Clinic Administration

  • SPRAVATO® is self-administered as a nasal spray under the supervision of trained healthcare staff.

  • Monitoring Period

  • After administration, patients remain in the clinic for a minimum of two hours for observation and safety monitoring.

  • Transportation Requirement

  • Patients must arrange transportation home and may not drive or operate machinery until the next day after a full night’s sleep.

  • Treatment Schedule

  • Treatment frequency varies. Many plans begin with twice-weekly visits and gradually decrease based on clinical response and provider recommendations.

    Safety Information & REMS Requirements

    SPRAVATO® carries important risks and is subject to a Boxed Warning. Potential risks include:

    • Sedation or extreme drowsiness

    • Dissociation or perceptual changes

    • Increased blood pressure

    • Respiratory depression

    • Risk of abuse and misuse

    • Suicidal thoughts or behaviors

    Because of these risks:

    • SPRAVATO® is only administered in a certified healthcare setting

    • Patients are monitored for at least two hours after each dose

    • SPRAVATO® is not dispensed for home use

    All patients must be enrolled in the SPRAVATO® REMS program prior to treatment.

    Insurance Coverage & Cost Considerations

    Coverage for SPRAVATO® varies by insurance plan.

    • Many commercial insurance plans and Medicare may provide coverage when medical criteria are met

    • Prior authorization is commonly required

    • Coverage often depends on documented history of treatment-resistant depression

    Our team can assist with:

    • Verifying benefits

    • Coordinating prior authorization paperwork

    • Discussing estimated out-of-pocket costs when available

    Coverage is not guaranteed, and patients are responsible for any non-covered services.

    When you’re ready, we’re ready — to help you move forward with confidence and care.