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Spravato is an in-clinic nasal spray that contains esketamine, a medication related to ketamine. It works on the brain’s glutamate system (not serotonin or dopamine), which helps regulate communication in mood networks and supports neuroplasticity - your brain’s ability to make new connections between brain cells. Many people feel rapid relief (hours to days), with benefits building over several weeks as sessions continue. Once you self-administer the nasal spray in the clinic, you then relax under supervision for 2 hours to ensure there are no adverse effects. Please note you are unable to drive the same day.
- Target: Esketamine affects NMDA receptors in the glutamate system. This shift in signaling can increase neuroplasticity, helping mood-related circuits function more effectively again.
- Why it can feel fast: Unlike many antidepressants that take weeks to work, esketamine has a direct impact on the neurotransmitter levels of glutamate, allowing for fast-acting effects. The intranasal delivery also facilitates efficient absorption of medication into the bloodstream.
How Esketamine Works in the Brain
Plain language:
Spravato helps your brain’s mood networks reconnect and communicate better, so you’re not stuck in the same depressive loop.
Evaluation & Eligibility
We confirm candidacy (treatment-resistant depression, safety screening, current medications) and explain expectations and after-visit planning.
In-Clinic Dosing & Supervision
You self-administer the nasal spray in a comfortable room, then remain for 2 hours of observation while a clinician monitors your response and vitals. You’ll need a ride home and should not drive until the next day.
Schedule & Phases
Treatment frequency starts higher and tapers as you improve, for example: twice weekly for 4 weeks (induction), followed by weekly and then less frequent maintenance as symptoms stabilize. We individualize the cadence to your response.
Label note:
Spravato is commonly used alongside an oral antidepressant as part of its approved use. We’ll review the plan with you.
Adults with treatment-resistant depression (after adequate trials of antidepressants) and some patients with depression with suicidal ideation under specific protocols. If you’re unsure, we’ll review your history and options - medication changes, TMS, Spravato, psychotherapy, or a combination - so we choose the path that fits you.
Take the Quiz:
Which Treatment is Right For Me?
Benefits
Within hours to days: Some people notice rapid improvement in mood or relief of suicidal thinking early in treatment.
Days to weeks:
Improvements in motivation, daily functioning, and emotional regulation typically build across the first month as sessions continue.
Maintenance: Benefits can persist for weeks between sessions; many patients move to every-other-week or monthly dosing to maintain progress.
Side Effects
Side effects (usually short-lived, same day): temporary dissociation, dizziness, nausea, sleepiness/fatigue, or increased blood pressure - typically peaking soon after dosing and resolving within the observation window. Long-term adverse outcomes are uncommon; fewer than ~7% discontinue due to side effects in longer studies. To ensure your safety, you are monitored on-site after each session for safety.
Spravato vs Ketamine vs TMS
- Spravato (esketamine): FDA-approved nasal spray for treatment-resistant depression; in-clinic dosing with required monitoring and an oral antidepressant in many cases.
- Ketamine (IV/IM): medication that is chemically distinct, though related to esketamine, that can be delivered orally, intravenously, or intramuscularly; it can be used off-label for depression
- TMS: a non-drug treatment using magnetic pulses to stimulate mood circuits; no anesthesia, no systemic medication - often a great adjunctive therapy option or treatment alternative.
How many sessions will I need?
We follow an induction → optimization → maintenance plan, tailored to results. Many people begin twice weekly, then step down in frequency as symptoms improve.
Can I drive afterward?
No. Plan a ride home and a calm evening; most people resume normal activities the next day.
Is Spravato covered by insurance?
Many insurers cover Spravato when the criteria are met. We’ll verify benefits, manage prior authorization, and explain any out-of-pocket costs. Read more: Pricing & Insurance
What about long-term safety?
You’re monitored on every visit. Long-term adverse effects are rare; risks like misuse are mitigated by in-clinic dosing and supervision. We’ll review your personal risk profile before starting.
Clear, evidence-based guides to help you choose the right path at Redbud.
Is TMS Right for Me?
A short self-assessment to help you explore whether TMS may be a good option for you.
Compare Treatments
Side-by-side look at TMS, accelerated TMS, Spravato, medication, and therapy, benefits, risks, and who each fits best.
Pros & Cons
A clear, side-by-side breakdown of our treatments so you can decide with confidence.
We keep costs simple so you can focus on getting better.
Insurance support: We verify your benefits and handle prior authorization.
Transparent self-pay: Written estimates before you start, no surprises.
Flexible ways to pay: Simple payment options, third-party financing may be available.
Spravato note: Out-of-pocket varies by plan; we confirm individually.
Talk to a Clinician
Call us at 540-212-9525 or complete the form below.
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We’ll help you explore if TMS, Spravato, medication, or therapy is the next best step.
Get answers about eligibility, coverage, and cost.
