Spravato® Frequently Asked Questions

Q. What is Spravato®?

A. 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.

Q. Do I need to go to a hospital?

A. No. Nasal esketamine must be given at a REMS (risk evaluation and mitigation system) certified 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.

Q. How do I start the Spravato® treatment process?

A. You can start your patient journey by calling us at (855)-940-4867. You will first talk with one of our intake specialists who will collect some basic information and arrange a meeting with one of our Consult Coordinators. The Consult Coordinator can meet with you in-person, over video conference or on the phone and will review your history and explain aspects of esketamine nasal spray treatment. The Coordinator will also explain payment options and insurance criteria. Next, you will meet with a Greenbrook provider for an evaluation which includes detailed questions about your history and symptoms. If the provider has determined that you’re a candidate for esketamine nasal spray and you are ready to move forward, they will create your individualized treatment plan. Please note that you must be on a concomitant oral antidepressant to begin Spravato® treatment.

Q. How long is a typical course of treatment?

A. 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 plans vary depending on clinical conditions.

Q. What is a Spravato® treatment session like?

A.  Don’t eat anything for two hours before, and don’t have any large amounts of fluids 30 minutes before treatment. After you arrive at the center, you will be placed into a reclining chair where you can sit back and relax. A technician will check your blood pressure and you will 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. You may be given one or two more spray devices separated five minutes apart depending on the dose prescribed by your provider. Your Care Team will supervise you for at least two hours. During treatment, you may feel dizzy, euphoric, or intoxicated. Throughout your treatment, our Care Team will be onsite to assist you. Your blood pressure will be checked upon arrival, 40 minutes in, and before you leave. Your blood oxygen level may be checked with a non-invasive light-based finger probe. After your two-hour monitoring, you may be groggy and woozy. You will need to avoid hazardous activity for the remainder of the day. This includes operating a motor vehicle, so you will need someone to drive you home from treatment. By the next morning, most people are ready to resume their day with no restrictions.

Q. Does my insurance cover Spravato®?

A.  Many major insurance companies cover ketamine based depression treatment if you haven’t gotten better after trying two oral antidepressants. One benefit of having treatment at a Greenbrook center is that our Care Team does all the work for you when it comes to insurance.