An FDA-Approved Path to Faster Depression Relief
Spravato (esketamine) is a purified form of ketamine, FDA-indicated for the treatment of depression. It is covered by most major insurance plans, both in combination with other antidepressants and as a stand-alone treatment.
FDA-Approved Medication for Difficult-to-Treat Depression
Spravato is a rapid-acting and effective treatment for difficult-to-treat depression. It is administered as a nasal spray under the supervision of a trained physician or nurse practitioner. Unlike traditional antidepressants that target serotonin, Spravato works through the glutamate system, the brain's most abundant chemical messenger. This distinct mechanism allows many patients to experience improvement within hours or days rather than the weeks required by conventional medications. At CARMAhealth, you self-administer the nasal spray in our certified treatment setting while your care team monitors your vitals and well-being for two hours after each dose. Spravato is always used alongside an oral antidepressant as part of a comprehensive treatment plan.
Proven Effective in Rigorous Clinical Trials
Spravato received FDA approval in March 2019 for treatment-resistant depression in adults, and its indication was expanded in 2020 to include major depressive disorder with acute suicidal ideation or behavior. It was designated a Breakthrough Therapy by the FDA, reflecting the urgent need for faster-acting treatments.
In the pivotal TRANSFORM-2 trial, patients receiving Spravato plus an oral antidepressant showed a statistically significant reduction in depression scores compared to those on an antidepressant and placebo alone. A narrative review published in Cureus found that esketamine demonstrates meaningful clinical outcomes across both treatment-resistant depression and MDD with suicidal intent, noting that it has earned FDA Breakthrough Therapy designation for both indications.
Long-term data from the SUSTAIN-3 extension study showed that nearly half of participants achieved remission with continued treatment, and relapse rates were significantly lower for patients who stayed on Spravato compared to those who switched to placebo. At CARMAhealth, your psychiatric practitioner integrates Spravato into a broader treatment plan that may include medication management, TMS therapy, or ketamine therapy depending on your needs.
What to Expect from Your First Visit
Start with a Psychiatric Evaluation
Your psychiatric practitioner conducts a thorough evaluation of your symptoms, medication history, and treatment goals. Together, you determine whether Spravato is the right next step for your care.
Verify Your Insurance Coverage
Our team contacts your insurance provider to verify Spravato coverage and obtain prior authorization. Most major plans cover Spravato for patients who have tried at least two antidepressants without adequate relief.
Begin In-Office Treatment Sessions
You self-administer the nasal spray in a comfortable, private treatment room. Your care team monitors your blood pressure, heart rate, and overall well-being for two hours after each dose. Sessions occur twice weekly during the first month, then weekly or biweekly.
Track Progress and Adjust Your Plan
Your psychiatric practitioner assesses your response after each phase of treatment and adjusts your plan accordingly. Many patients notice meaningful improvement within the first few weeks.
Most Major Plans Accepted
We accept 15+ insurance plans and offer self-pay options for services not covered by insurance.
Aetna · BCBS · Cigna · United Healthcare · Humana · and 6 more
Frequently Asked Questions About Spravato
Spravato (esketamine) is an FDA-approved nasal spray administered in-office, while ketamine therapy (KT) uses generic ketamine via intramuscular injection or intravenous infusion off-label. Because Spravato is FDA-approved, it is covered by most major insurance plans. KT is typically not covered by commercial insurance, though some plans make exceptions. Both treatments are offered at CARMAhealth and supervised by physicians. Your psychiatric practitioner can help you determine which approach is best for your situation.
Yes. Most major insurance plans cover Spravato for treatment-resistant depression, including Aetna, BCBS, Cigna, and United Healthcare. Coverage typically requires documentation that you have tried at least two antidepressant medications without adequate improvement. CARMAhealth's team handles insurance verification and prior authorization on your behalf. Contact us at (512) 212-4670 to check your coverage.
The most common side effects are temporary dissociation (a feeling of disconnection or detachment), dizziness, nausea, and sedation. Some patients experience a transient increase in blood pressure. These effects typically peak within 40 minutes of administration and resolve within two hours, which is why every session includes a monitored observation period. You should not drive or operate heavy machinery until the following day.
Plan for approximately two and a half hours per visit. The nasal spray administration itself takes only a few minutes, but the FDA-required REMS monitoring protocol means you will be observed in our office for at least two hours afterward. During this time, you can relax, read, or rest. Most patients use twice-weekly sessions for the first month, then taper to weekly or biweekly visits.
Spravato is approved for adults with treatment-resistant depression, defined as inadequate response to at least two antidepressant medications in the current episode. It is also approved for adults with major depressive disorder who have active suicidal ideation or behavior. Your psychiatric practitioner will evaluate your complete history during a psychiatric evaluation to determine whether Spravato is appropriate for you.
Clinician-Directed Spravato Treatment
Every Spravato treatment at CARMAhealth is supervised by a board-certified physician or psychiatric nurse practitioner who monitors your response, manages your overall treatment plan, and coordinates with other therapies when needed.
Start Feeling Like Yourself Again
Whether you're exploring treatment for the first time or looking for a new practitioner, our psychiatrists are here to listen.
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