Esketamine Nasal Spray at a Glance

1)  Spravato® is an FDA-approved esketamine nasal spray, a refined form of ketamine, used to treat adults with treatment-resistant depression and depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions. Spravato® can be administered as stand-alone therapy or in combination with other oral antidepressant medications.

2)  Esketamine nasal spray (Spravato®) is the only FDA-approved ketamine-based depression treatment.

3) Available only through a restricted program called the Spravato® Risk Evaluation and Mitigation Strategy (REMS) Program. 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. 

4)  Covered by most major insurance following two failed antidepressant trials; Medicaid and Medicare accepted in select locations (Call 855-494-4867 for more information).

5)  Treatment is performed in an office with individual treatment spaces with comfortable seating and spa-like setting. Average treatment duration is two hours. A typical treatment plan consists of:

• 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 plans vary depending on clinical conditions.

6) Common side effects include include dissociative or perceptual changes (including distortion of time, space, and illusions), dizziness, nausea, and sedation.

7)  Possible contraindications, it is important to speak with a Greenbrook representative or provider before treatment if a patient has:

 • History of abnormal blood vessels, such as an Arteriovenous Malformation or Aneurysm

 • History of hyper-sensitivity to esketamine or ketamine

 • High blood pressure that is not currently under control with medications or lifestyle management (blood pressure over 140/90)