Spravato: a different kind of depression treatment.
Spravato is a nasal spray, FDA-approved for adults whose depression hasn’t responded to antidepressants. It works on a different system in the brain than the medications you’ve already tried, which is why it can help when they haven’t.
Esketamine, as a nasal spray, given in a certified office.
- The medication is esketamine, a form of ketamine developed and approved specifically for depression.
- You take it yourself, as a nasal spray, in our office with one of our Sherpas guiding you (the specially trained team members who look after you on every treatment day), then rest for at least two hours while our team monitors you.
- The side effects mostly stay in the office. Most people feel sleepy or a little floaty for an hour or two, with our team beside them, and go home feeling like themselves, instead of living with a daily pill’s side effects. Side effects, in full.
- It’s FDA-approved for treatment-resistant depression in adults, on its own or with an oral antidepressant.1 It is also approved, together with an oral antidepressant, for adults with major depression who have suicidal thoughts or actions.
- It’s only given in certified offices, under a federal safety program called REMS. You never take it home.
Why past failures don’t predict this one.
Most antidepressants act on serotonin, norepinephrine, or both. Spravato acts on glutamate, the brain’s main signalling chemical, by a different route entirely.
That’s why it can help people whose history suggests nothing will. Trying another medication that works the way the last ones did is a different decision from trying one that doesn’t.
Adults whose depression hasn’t lifted.
- You’ve tried at least two antidepressants without enough relief.
- You don’t have to stop what you’re on. Spravato can be used alone or alongside an oral antidepressant.
- A few conditions rule it out, such as certain blood-vessel problems. We check at your evaluation. Could Spravato be right for you?
Wondering whether Spravato is for you? Check if you qualify.
A two-minute read: who Spravato is for, what rules it out, and how the evaluation works.
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 evaluationHead to head with a standard alternative.
The largest comparison trial, ESCAPE-TRD, put Spravato against quetiapine, a common add-on medication for depression that hasn’t responded, in 676 adults.2
- At week 8: 27.1% were in remission on Spravato, against 17.6% on quetiapine.
- At week 32: 55.7% against 36.3%.
- Stopping because of side effects: 4.5% on Spravato, against 10.1% on quetiapine.
Over half of the people on Spravato were in remission by the end of the study, and fewer stopped because of side effects. More on the research.
You can stay on it for as long as you need it.
Finding something that finally helps is the hard part. In the SUSTAIN-1 trial, people who responded to Spravato and kept going stayed well longer than people who stopped,3 and in the long-term SUSTAIN-3 study, patients were followed for up to six and a half years with no new safety signals,4 one of the longest safety records of any psychiatric treatment. We also check in with you regularly to find the least frequent schedule that keeps you well: for some people that’s once a week, for others once a month, and everywhere in between.
What people ask about Spravato itself.
What is Spravato?
Spravato is esketamine, an FDA-approved nasal spray for adults with depression that hasn’t responded to at least two antidepressants. It’s given in certified offices, where you rest and are monitored for at least two hours afterward.
How does Spravato work?
Most antidepressants act on serotonin and norepinephrine. Spravato acts on glutamate, a different signalling system in the brain, which is why it can help when other medications haven’t.
Is Spravato the same as ketamine?
Related, but not the same. Spravato is esketamine, one form of the ketamine molecule, made as a nasal spray and FDA-approved specifically for depression. Unlike IV ketamine, it’s covered by most insurance. Spravato vs ketamine.
Do I have to stop my antidepressant?
No. Spravato is approved on its own or with an oral antidepressant for treatment-resistant depression, so nothing has to be taken away to start. We decide together what’s right for you.
Can I take Spravato at home?
No. Every dose is taken in a certified office, and you stay for at least two hours afterward while our team monitors you. That’s a federal safety requirement, and it’s there to protect you.
How quickly does it work?
Some people notice a change within the first weeks of treatment. In the head-to-head trial, the Spravato group had already pulled ahead by week eight.