Is Spravato addictive? Here's what the evidence shows.
Spravato has a potential for misuse, like other medicines related to ketamine, and that's exactly why it's handled the way it is: every dose is given in a certified office, watched for two hours, recorded, and never sent home with you. In a long-term study of people treated for up to six and a half years, no new safety concerns appeared.
How does supervised dosing prevent addiction to Spravato?
Supervised dosing prevents addiction to Spravato by taking it out of anyone's hands between visits. Under the Spravato REMS program, a federal safety program, it can only be given in certified offices:
- It never goes home. You take the spray in our office, in front of our team.
- Every dose is recorded. The amount, the date and how you did.
- You're watched for two hours. Then a clinician checks you're ready to leave.
- The schedule is set. Twice a week to start, then less often, never on demand.
The rules exist because the molecule is related to ketamine.
Those rules are the reason Spravato can be offered safely to people who've tried everything else. How the REMS program protects you.
Is Spravato a controlled substance or a narcotic?
Spravato is a Schedule III controlled substance, the same federal category as some prescription medicines like testosterone or certain codeine combinations. It isn't an opioid or a narcotic painkiller. Schedule III means it has an accepted medical use and a moderate-to-low potential for dependence, which is why it's tracked closely.
What do long-term studies show?
SUSTAIN-3 followed people on Spravato for up to about six and a half years and found no new safety concerns over that time, with no evidence of harm to memory or thinking. What years of data show.
Is Spravato the same as street ketamine?
No. Spravato's active ingredient, esketamine, is one half of the ketamine molecule, made to pharmaceutical standards and delivered in a measured 28 mg device. It's given at a set dose, on a set schedule, in a certified office. The misuse problems people associate with ketamine come from large, frequent, unsupervised doses, which is the opposite of how Spravato is given. Spravato vs ketamine.
How do we watch for misuse?
The label asks every prescriber to assess the risk of misuse before starting and to keep watching for it throughout (Spravato Prescribing Information). In practice that means an open conversation about substance use at your evaluation, a dose that only ever exists in our office, and a team that sees you twice a week at the start and notices changes early.
Does Spravato cause withdrawal?
Spravato isn't known to cause withdrawal at prescribed, supervised doses. In clinical studies, no withdrawal symptoms were seen in the four weeks after people stopped esketamine (Spravato Prescribing Information). The label notes that withdrawal has been reported with heavy, frequent, long-term misuse of ketamine, a very different situation from a measured dose once or twice a week. The real reason to plan any stop with us is the depression itself: stopping early raises the chance it comes back.
Can you take Spravato if you've struggled with substance use?
Often, yes. A history of substance use doesn't automatically rule you out. We talk it through openly at your evaluation, and the supervised setting is designed with exactly this concern in mind. In our clinical experience, people often tell us they have fewer cravings for alcohol and other substances once treatment is under way. Who shouldn't take Spravato.
If antidepressants haven't worked for you, Spravato works on a different system.
Most antidepressants act on serotonin or norepinephrine. Spravato acts on glutamate, the brain's main signalling chemical, which is why it can help people whose history suggests nothing will. The safeguards around it are what make that possible.
A visit or two a week, given by us.
A daily antidepressant is in your medicine cabinet every day. Spravato is in our office, on a schedule, and its effects stay inside the two hours you rest with us.
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.
Check if you qualify, and ask us anything.
Answer a few questions to see if Spravato is likely to be an option. We'll go through any concern about dependence at your evaluation.
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 and addiction.
Is Spravato addictive?
Spravato has a potential for misuse, which is why it's only given and monitored in certified offices and never taken home.
Is Spravato a narcotic?
No. It isn't an opioid or a narcotic painkiller. It's a Schedule III controlled substance because it's related to ketamine.
Can you get high on Spravato?
It can make you feel detached or dreamlike for a while after a dose, which eases within the two hours you rest with us. What Spravato feels like.
Do people crave Spravato between visits?
Cravings aren't a common experience with supervised Spravato treatment. If you ever notice one, tell us; it's exactly the kind of thing we want to hear about, and we'll talk it through with you.
Will I be dependent on Spravato for life?
No. Staying on maintenance protects your progress, but visits space out as you do well, and any decision to stop is planned with you so the depression doesn't come back.
Is esketamine a controlled substance?
Yes. Esketamine, the active ingredient in Spravato, is Schedule III under federal law.