Spravato® is nasal esketamine, a more specific form of ketamine designed to treat depression.

Spravato® takes the effective part of ketamine and isolates that and then gets rid of the sedating part of ketamine that is not believed to be as important for depression.

Spravato® esketamine nasal spray is FDA-approved for people with depression who have not experienced adequate improvement with antidepressant medications.

A typical round of esketamine nasal spray treatment is broken up into three phases: 

• Induction, Week 1-4: 2 treatments a week 
• Maintenance, Week 5-8: 1 treatment a week
• Maintenance, Week 9+: 1 treatment every 1-2 weeks

Treatment plan varies by individual. Some patients complete maintenance after the initial induction plan.

Before each appointment, avoid eating for two hours and drinking large amounts of fluid for 30 minutes.

Each session takes place at a private, spa-like Greenbrook center. Once you arrive, you'll sit in a comfortable recliner, and a technician will check your blood pressure. You will then complete a short form, after which you will be handed a nasal spray device to self-administer. We will go over how to administer the spray to yourself. 

Throughout your treatment, our care team will be onsite to assist you. Your blood pressure is checked at the start of the session, 40 minutes into treatment, and before you leave the Greenbrook center. You must stay in the center for at least two hours. Ensure you have someone to drive you home, as you will not be able to operate a motor vehicle for the rest of the day. 

Your Greenbrook provider will determine the dose of Spravato® based on your treatment plan. There will be 2-3 sprays self-administered in each nostril, depending on the dose prescribed by your provider.

That's okay! Our Consult Coordinators will help you decide if Spravato® depression treatment is right for you. If it isn't, Greenbrook also offers NeuroStar TMS therapy, which is a non-drug, non-sedating FDA-cleared treatment for depression. You can learn more about NeuroStar TMS by asking your Consult Coordinator or taking our TMS quiz. 

Yes. You must be on an antidepressant medication to receive Spravato® treatment.

No. Nasal esketamine must be given at a certified REMS (risk evaluation and mitigation system) center, such as a convenient outpatient Greenbrook Mental Wellness center. 

The medical staff at Greenbrook’s certified treatment centers are trained to prescribe, dispense, and administer Spravato®, and we have established processes and procedures in accordance with the REMS program.

No. Esketamine nasal spray is FDA-approved for people with depression who have not experienced adequate improvement with antidepressant medications.

Greenbrook Mental Wellness recommends calling for more information on whether treatment is right for you. Below are some of the common contraindications, but each patient's journey is unique.

• Uncontrolled hypertension
• History of stroke or brain bleeds
• Abnormal blood vessels at risk of bleeding, such as aneurysms or arteriovenous malformations (AVMs)
• Sensitivity to esketamine or ketamine

View Indications and Important Safety Information.

Yes! Many major insurance companies cover Spravato® depression treatment if you haven’t gotten better after trying two oral antidepressants.