A treatment we offer · For treatment-resistant depression
SPRAVATO® (Esketamine)
A nasal-spray treatment, FDA-approved for adults with . Unlike traditional antidepressants that work on serotonin or dopamine, SPRAVATO works on signaling, and often reduces symptoms in days rather than weeks.
What SPRAVATO is
SPRAVATO (also called esketamine) is a prescription nasal spray derived from ketamine. The FDA first approved it in 2019 for adults with treatment-resistant depression when used alongside an oral antidepressant. In January 2025, it was approved on its own — clinically called .
It’s given under direct clinical supervision through a program called , which is why you’ll receive each dose here at the office rather than take it home.
What a session looks like
Plan on about two and a half hoursin the office each visit. Most of that time is quiet monitoring — you can bring headphones, a book, or just sit in the dimmed room.
- Before —eat lightly 2 hours ahead, skip caffeine the morning of, and arrange a ride home. You can’t drive for the rest of the day.
- During — you spray the dose yourself, with us in the room. Most people feel the medication within 20 minutes.
- After —you’ll stay for a 2-hour observation window where we check blood pressure and see how you’re feeling. Then your ride home picks you up.
The usual schedule is twice a week for the first four weeks, then slowly tapered. We adjust together based on how you’re responding.
Common effects & who it’s not for
SPRAVATO is generally well-tolerated, but it does have effects worth knowing about before deciding together if it’s the right fit.
Most common effects— usually during or shortly after the session, fading within a few hours:
- Dissociation — a feeling of being outside your body or that the room feels unreal. This is expected, and it passes.
- Sedation —sleepiness or light-headedness (part of why you can’t drive).
- Blood pressure elevation — a temporary rise, which is why we monitor during and after.
- Nausea, headache, or dizziness — less common, and usually mild.
Who qualifies
SPRAVATO is approved for adults (18+) with treatment-resistant depression — typically meaning you’ve tried at least two different oral antidepressants at the usual doses and didn’t get enough relief. If you’re not sure whether that describes your history, that’s exactly the kind of thing we’ll sort out together at the first visit.
Next step
Wondering if SPRAVATO fits?
Book a visit with Vanessa to walk through your history — what you've tried, what's worked, what hasn't — and whether SPRAVATO could be part of a plan that makes sense for you. No pressure. No upsell.