Can you take Spravato at home? No, and here's why that helps you.
You can't take Spravato at home. Under a federal safety program, every dose is given in a certified office, where you take the spray yourself and rest for at least two hours while a team monitors you. The upside is that the strange part of a session happens somewhere safe, and you go home afterward feeling like yourself.
Why can't Spravato be taken at home?
Spravato can't be taken at home because it's only available through the Spravato REMS, a federal safety program (Spravato Prescribing Information). Under the program:
- It's only shipped to certified healthcare settings, never to patients.
- You take it in the office, under direct observation.
- You're monitored for at least two hours, including blood pressure.
- A clinician checks you're ready before you leave.
The hard part happens with us, not alone at home.
Dissociation and the blood pressure rise are temporary and strongest early. Having them in a recliner, with our team beside you, is what makes them uneventful.
How is Spravato different from at-home ketamine?
Spravato is different from at-home ketamine services in approval, supervision and cost.
| Spravato in our office | At-home ketamine services | |
|---|---|---|
| FDA-approved for depression | Yes | No. Ketamine is approved as an anesthetic; depression use is off-label |
| Where you take it | A certified office | Your home |
| How it reaches you | It never leaves our office | Mailed to your home, often weeks of doses at once |
| The dose | A measured, FDA-approved 28 mg device every time | Compounded lozenges or sprays, not checked by the FDA for quality, absorbed differently from dose to dose |
| Who watches you | Our team, for at least two hours | Usually a family member or a video check-in |
| Insurance | Covered by most plans; most patients pay $0 to $40 a treatment | Not covered by insurance. You pay out of pocket, every time |
Spravato details from the SPRAVATO® Prescribing Information. At-home services vary.
Is at-home ketamine safe?
We don't think so, and we don't recommend it. In 2023 the FDA warned patients about compounded ketamine taken at home for mental health conditions, noting that the risks are greater without a healthcare provider there to monitor for sedation, dissociation and rises in blood pressure (FDA, October 2023).
Beyond the missing supervision, four things concern us:
- Nobody trained is in the room. The effects we watch for during your two hours with us, the floaty feeling, sleepiness and the blood pressure rise, happen at home with no one checking.
- It comes by mail. A controlled substance arrives at your door, often several weeks' supply at once, and a late or lost package can leave you waiting between doses.
- The dose is unpredictable. At-home ketamine is usually a compounded lozenge or spray. Compounded medicines aren't checked by the FDA for quality, and how much a lozenge delivers varies from person to person and from one dose to the next.
- Insurance doesn't cover it. At-home ketamine isn't covered by insurance, so you pay out of pocket for every dose and every check-in. Spravato is covered by most plans, and most of our patients pay $0 to $40 a treatment. Cost and insurance.
Why does the two-hour wait matter?
The two-hour wait matters because that's when Spravato's effects peak and settle. Blood levels peak 20 to 40 minutes after the dose, and the blood pressure rise peaks about 40 minutes after the dose (Spravato Prescribing Information). The strongest effects fall inside those first two hours, and we check your blood pressure before you go. By the time you leave, most people feel close to themselves.
The hard part should happen with a team beside you.
Every Spravato dose we've given, more than 30,000 of them, has come with two hours of our team's attention. That's the standard we think depression treatment of this kind deserves.
What happens at an in-office Spravato visit?
- ArriveCheck in, settle into a reclining chair, and we take your blood pressure.
- Your doseYou take the spray yourself, two or three devices a few minutes apart, with a Sherpa guiding you.
- RestMusic, an eye mask, quiet. We check on you and your blood pressure through the two hours.
- HomeA clinician confirms you're ready, and someone else drives you home. You drive again the next day.
In-office treatment that fits your life.
Four offices in Bridgewater, Morristown, Nutley and Hoboken; evening and Saturday hours; and help setting up covered rides for NJ Medicaid patients. The evaluation itself is usually by video, from home, within one business day. Offices and hours.
Twice a week to start, then less.
The first month is the busiest. After that, visits drop to weekly, then weekly or every other week, instead of a pill every day. How often and how long.
30 doses
Every day.
Side effectsEvery single day: sedation, dry mouth, sexual side effects, weight gain.
8 visits
Twice a week.
4 visits
Down to once a week.
2–4 visits a month
Down to once a week or every other week. Dashed: weeks you may or may not need.
Side effectsMostly gone by the end of each visit.
Find out if Spravato is an option for you.
Answer a few questions and we'll tell you whether Spravato is likely to fit, and what it would cost with your insurance.
Name, date of birth and insurer. We check your plan and call you back. No commitment.
Check my coverageRegister once, and our team starts your insurance check and reaches out to schedule your evaluation.
Request an evaluationWhat people ask about Spravato at home.
Can Spravato be prescribed for home use?
No. Spravato is only given in certified healthcare settings, under supervision, with at least two hours of monitoring.
Can I get Spravato through telehealth?
Your evaluation can be by video, from home. The treatment itself is always in a certified office.
Is at-home ketamine the same as Spravato?
No. Spravato is esketamine, FDA-approved for treatment-resistant depression and covered by most insurance. At-home ketamine is used off-label for depression and is usually self-pay. Spravato vs ketamine.
Can a nurse give me Spravato at home?
No. The REMS program only allows Spravato to be given in certified healthcare settings, not in a patient's home.
Is there an at-home alternative to Spravato?
Not one that's FDA-approved for treatment-resistant depression. At-home ketamine is a different medicine, used off-label, not covered by insurance, and without anyone trained in the room. We don't recommend it.
Why do I have to stay two hours after Spravato?
Because its effects, like dissociation and the blood pressure rise, are strongest in that window. We monitor you until they ease.