What Does Esketamine (Spravato) Treat?

Esketamine (Spravato) is intended to be taken along with an oral antidepressant. It is in a class of medicine called NMDA receptor antagonists, which may work in part by helping to repair damaged connections in the brain that result from long-standing stress. Esketamine may also be referred to as s-ketamine. Chemically it is “one half” of ketamine with its mirror image twin being r-ketamine.

Although it can be a very effective treatment that may work more quickly than typical antidepressants, it is reserved for those with treatment resistant depression. Treatment resistance is defined as a lack of response to two past treatments at an adequate dose and for a long enough period of time (typically 10-12 weeks).

a doctor holding spravato esketamine nasal spray

How Esketamine Nasal Spray Works

Drug Administration

During a Spravato treatment, the nasal spray is self-administered by the patient in a certified office setting under the supervision of board-certified mental health providers such as psychiatrists and psychiatric mental health nurse practitioners. The patient is taught how to correctly administer the medicine in the office.


Treatments are given twice weekly for the first four weeks, then once weekly for the next four weeks, then weekly, every other week, or less often as directed by the doctor. Unlike other prescription medications, Spravato must be administered under medical supervision in a certified center.

Monitoring Process

After the patient administers the nasal spray, there is a monitoring period of at least two hours before going home. At Actify centers, we have comfortable patient lounges where patients may relax, work, or begin therapy during this recovery. Longer term, some may continue Spravato on a maintenance basis, while others may transition to oral medication, talk therapy, or other options.

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health woman after ketamine infusion therapy

Esketamine Nasal Spray Side Effects

Spravato is very similar to ketamine, a medicine that Actify has safely delivered over 50,000 times since 2011. As with ketamine, Actify ensures that Spravato administration is done safely and comfortably. However, as with any medication, some may experience side effects. During appointments, our patients are closely monitored by appropriately licensed staff. Potential side effects include:

  • Dizziness or Vertigo
  • Nausea
  • Sedation (sleepiness) 
  • Dissociation (feeling disconnected from yourself)
  • Increased blood pressure or heart rate
  • Headache

These side effects are typically limited to the time in the office.

Spravato Insurance Coverage

Many insurance companies do cover Spravato treatment, however it does vary depending on your plan’s coverage. Actify is actively enrolling in those plans for direct coverage so patients who qualify are able to get the care they need. If you or someone you know is struggling with major depression and have yet to find relief from two or more treatments, Spravato may be a treatment option for you.






ComPsych | TriCare East


CareFirst | ComPsych | TriCare East

New Jersey

ComPsych | TriCare East

New York


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ComPsych | TriCare East




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