SPRAVATO^® (esketamine)

SPRAVATO^® (esketamine) is an FDA-approved breakthrough treatment for treatment-resistant major depressive disorder (TRD) in adults. It is an intranasal medicine prescribed along with an oral antidepressant.

Clinical trials have shown a response rate of over 60% and a 52% remission rate in patients treated with SPRAVATO^® with minimal side effects.

What is SPRAVATO?

SPRAVATO (generic name: esketamine) is a prescription nasal spray primarily used to treat adults with treatment-resistant depression (TRD) and major depressive disorder (MDD) accompanied by acute suicidal ideation or behavior. It is administered in the doctor’s office, where patients are monitored for 2 hours.

How does SPRAVATO work?

Unlike traditional antidepressants that target serotonin or norepinephrine, SPRAVATO works by blocking the NMDA receptor, which affects glutamate, a neurotransmitter involved in mood regulation. This mechanism can help rapidly improve symptoms of depression, often within hours to days, unlike traditional antidepressants, which can take weeks.

Who should consider SPRAVATO?

SPRAVATO is for use alone or in combination with an oral antidepressant for Adults with treatment-resistant depression (MDD patients who have had an inadequate response to 2 or more oral antidepressants).

SPRAVATO is for use in combination with an oral antidepressant for Depressive symptoms in adults with MDD with acute suicidal ideation or behavior (MDSI).

Insurance Coverage

Your individual insurance plan determines coverage for SPRAVATO. Many major insurance companies cover it, but specific requirements like prior authorization and proof of treatment history may apply.

If you have a commercial insurance plan, there is a copay assistance program that may reduce the cost of the medication to as little as $10 per treatment.

At this time, Nashville Neurocare can see patients with the following insurance providers:

If you have questions about your coverage or eligibility, feel free to contact us—we’re happy to help verify your benefits and guide you through the process. Coverage for SPRAVATO can vary depending on your insurance plan.

Schedule for SPRAVATO

SPRAVATO offers the freedom to choose your treatment approach*

Start with 56 mg or 84 mg, alone or in combination with an oral antidepressant, and an individualized dosing schedule. Evidence of therapeutic benefit should be evaluated at the end of the induction phase to determine need for continued treatment.

Start with 56 mg or 84 mg

If clinically warranted, you may start a patient on SPRAVATO alone — without the need to combine it with an oral antidepressant
SPRAVATO now offers more flexibility in treatment approach, dosing, and post-induction frequency

Evidence of therapeutic benefit should be evaluated at the end of the induction phase to determine need for continued treatment.

*SPRAVATO® [Prescribing Information]. Titusville, NJ: Janssen Pharmaceuticals, Inc.

Getting Started

Free Consultation > Evaluation with Provider > Begin Treatment

Frequently Asked Questions

I am approved. How do I prepare for my treatment?

Stay well hydrated the day before your treatment. It helps with any nausea that may be experienced. Do not have anything to eat two hours before your appointment and nothing to drink an hour before. Take all your current medications as prescribed – unless directed otherwise by the provider. Arrange a ride from the office as you are not permitted to drive yourself after treatment.

What should I expect from my first treatment?

Everyone’s experience is a little different, but here are some common sensations people report during or after their first SPRAVATO session:

During the Treatment (First 40 Minutes or So):

Dissociation: You may feel like you’re “outside your body,” like you’re observing yourself from the outside, or things may feel dreamlike or floaty. This is normal and typically fades within an hour or two.
Dizziness or lightheadedness: A common side effect—many people describe it like feeling tipsy or off-balance.
Sleepiness or fatigue: You might feel very relaxed or even sleepy.
Blurred vision or altered perception: Things may look or sound different—some people describe it like being in a fog.
Mild nausea or feeling unsteady: This can happen, especially if you ate too recently.

After the Treatment:

Most of these sensations begin to fade within 1–2 hours.
You’ll stay in the clinic the whole time, and staff will be there to support you.
Some people feel mentally clearer or lighter later in the day, while others may feel tired and need to rest.

Who would NOT be a candidate for SPRAVATO?

SPRAVATO is contraindicated in patients with the following conditions:

Aneurysmal vascular disease (including thoracic and abdominal aorta, intracranial, and peripheral arterial vessels) or arteriovenous malformation
History of intracerebral hemorrhage
Hypersensitivity to esketamine, ketamine, or any of the excipients.
Those who are pregnant, trying to become pregnant, or breastfeeding.

SPRAVATO® (esketamine)

SPRAVATO® (esketamine) is an FDA-approved breakthrough treatment for treatment-resistant major depressive disorder (TRD) in adults. It is an intranasal medicine prescribed along with an oral antidepressant.