Spravato for Treatment-Resistant Depression

Spravato (esketamine) is a prescription nasal spray medication. It is FDA-approved, in conjunction with an oral antidepressant, for adults with treatment-resistant depression and for depressive symptoms in adults with major depressive disorder with acute suicidal ideation or behavior.

Spravato works differently from conventional antidepressants and is administered under direct medical supervision in a certified healthcare setting — it is not taken at home.

Alliance Psychiatric Group provides Spravato at our certified Lake Forest treatment site. Not every patient qualifies — whether Spravato may be appropriate for you must be determined by a qualified provider after a comprehensive evaluation of your medical and psychiatric history.

Spravato may be considered for adults with major depressive disorder who have not responded adequately to other antidepressant treatments. It is not appropriate for everyone.

Eligibility and appropriateness must be determined by a qualified clinician after a comprehensive evaluation of your medical and psychiatric history.

Spravato is self-administered as a nasal spray under the supervision of a healthcare provider at a certified treatment site. Because the medication can cause temporary effects such as sedation, dissociation, and elevated blood pressure, patients are monitored for a period of time after each dose — typically around two hours.

Patients cannot drive or operate machinery until the day after treatment, following a restful sleep, so transportation must be arranged for treatment days.

Spravato is available only through a restricted program called the Spravato REMS (Risk Evaluation and Mitigation Strategy) because of risks of serious adverse outcomes from sedation, dissociation, respiratory depression, and the potential for abuse and misuse.

Your care team monitors blood pressure and overall response during each visit and coordinates ongoing treatment planning with your prescribing clinician.

Coverage for Spravato varies by insurance plan and typically requires prior authorization. Our staff can help you understand the process, but we cannot guarantee approval or coverage.