We are excited to offer Spravato (esketamine) treaments for treatment resistant depression.

Q: What is Spravato® and how is it different from other antidepressants?
A: Spravato® is the brand name for esketamine, a fast-acting antidepressant nasal spray. It’s the first antidepressant in decades that works in a whole new way, targeting the glutamate neurotransmitter system rather than the serotonin system. This difference allows Spravato® to often relieve depression symptoms when traditional antidepressants have failed. It’s also why Spravato® can work much faster – sometimes within hours or days – whereas pills can take 4–6 weeks to show effect. Spravato® is FDA-approved for adults with treatment-resistant depression (people who haven’t responded to at least two other antidepressants), and it’s only available at certified clinics like ours (you cannot get it at a regular pharmacy or take it home). In short, Spravato® is a cutting-edge option for hard-to-treat depression, offering new hope through a novel mechanism and supervised, in-clinic care.

Q: Who qualifies for Spravato® treatment? Do I meet the criteria?
A: Spravato® is intended for adults with treatment-resistant major depression – typically defined as having tried two or more antidepressant medications, at adequate doses for an adequate duration, without sufficient improvement. Our team will review your medical history to confirm this. If you have been struggling with depression despite trying therapy and multiple medications, you likely meet the criteria. Spravato® is not a first-line treatment; it’s reserved for cases that haven’t responded to other approaches. Additionally, Spravato® may be an option if you experience major depression with acute suicidal ideation (thoughts of suicide), to rapidly reduce those dangerous symptoms. During your evaluation, we will also check for any health conditions that might exclude Spravato® – for example, uncontrolled blood pressure, certain heart or brain conditions, or pregnancy. The best way to know if you qualify is to schedule a consultation with us. We’ll carefully assess your situation and either move forward with Spravato® or recommend alternatives that suit your needs.

Q: Is Spravato® safe? What are the side effects?
A: Yes, Spravato® is considered safe when used as directed in a medical setting. It underwent extensive clinical trials before FDA approval in 2019, demonstrating both its effectiveness and manageable safety profile. However, because Spravato® can cause certain side effects – like sedation or a temporary feeling of disconnection (dissociation) – it is only administered under medical supervision to ensure patient safety. Common side effects include feeling dizzy or sleepy, nausea, increased blood pressure for a short time, headache, and that “dreamy” or detached sensation during the first hour after dosing. These effects are generally temporary and will wear off within the two-hour monitored period (we will keep you until they do). We watch you closely and make you comfortable if any side effect arises. Serious risks (like severely elevated blood pressure or allergic reactions) are very rare, and our team is trained to respond immediately. Spravato® has a low risk of addiction when used in the controlled setting as prescribed for depression – it is a form of ketamine, which has abuse potential, but the clinic-based usage and oversight prevent misuse. Overall, Spravato’s safety record in real-world use is strong, and the REMS program ensures that every precaution is taken. We will thoroughly educate you on what to expect, and you will be in experienced hands throughout the process.

Q: What does a Spravato® treatment feel like? Will it hurt or be uncomfortable?
A: Spravato® treatment is not painful – there are no needles or IVs involved. The medication is a nasal spray that you administer yourself under guidance. You might feel a brief cool mist or slight stinging in your nose with each spray, but most people find it very tolerable (no worse than a typical nasal allergy spray). Within minutes, as the medicine starts to work, you may experience some odd sensations. Many patients report feeling a bit lightheaded or “floaty.” You could feel drowsy or very relaxed, and sometimes people describe a tingling body sensation or a sense that time is moving slowly. Some experience mild dissociation – a sense of being detached from your surroundings. This can feel strange, but not necessarily scary; often patients are prepared for it and even find the experience interesting or calming. We make the environment as comfortable as possible: you’ll be in a recliner, you can bring a blanket or headphones, and the room is peaceful and dimly lit. Our staff is there to reassure you if you feel anxious at any point. By the end of the session, these effects subside. Most people leave feeling a little tired but otherwise okay. We’ll discuss all these sensations with you ahead of time so you know what’s normal. Every person’s experience is a bit different – some just feel relaxed and take a nap; others have mild hallucination-like effects (like dream images behind closed eyes). Rest assured, these feelings are transient and wear off within a couple of hours, and you’ll be back to your usual state by the next day.

Q: How soon will I notice results?
A: Spravato® can work remarkably quickly. Many patients begin to feel a reduction in depression symptoms after the first few sessions, sometimes even after their very first treatment. In clinical studies, some patients reported improvement in mood as early as 24 hours after the initial dose. This rapid action is one of the biggest advantages of Spravato®. However, everyone’s response is unique. Some people experience small changes initially (for example, slightly improved sleep or appetite, or a tiny spark of hope) and then larger improvements after 2–4 weeks of treatment. The typical course is to evaluate response at the end of the Induction phase (about 4 weeks) – by then, many patients have a clear response, with significantly less depression. If you haven’t felt any change by that point, our team will reassess whether to continue. For those who do respond, the improvement often continues or solidifies over the following weeks with maintenance sessions. It’s important to keep realistic expectations: Spravato® is effective, but not every single person will respond, and it’s not instant happiness. That said, about 70% of TRD patients get some benefit, and a substantial portion achieve remission (minimal symptoms) within a month or two. We will track your progress at each visit and tailor the plan to maximize your chance of success.

Q: How long will I need to continue Spravato® treatments?
A: The length of Spravato® therapy varies per individual. Depression is a relapsing condition for many, so once Spravato® helps you improve, we generally recommend continuing maintenance treatments for a while to prevent relapse. The initial intensive phase is about 1 month (8 sessions over 4 weeks). After that, if you’re doing well, we taper to weekly for a month, then perhaps every other week. Some patients may continue maintenance treatments for 6 months, 12 months, or even longer, at a frequency that keeps their symptoms in check (e.g., biweekly or monthly). In clinical studies, staying on Spravato® maintenance significantly reduced the chance of depression returning. When you and the doctor feel it’s appropriate to stop, we’ll discontinue gradually and keep a close eye on your mood. Some individuals may transition off Spravato® back to only oral medications or other therapies. Others might restart Spravato® in the future if depression comes back. It’s very personalized – our goal is to find the shortest duration of treatment that still provides lasting relief. We will have regular discussions about your progress and treatment timeline. Ultimately, you won’t be on Spravato® forever; it’s a bridge to get you out of the depths of depression, and then we’ll ensure you have the support to maintain wellness afterward.

Q: Will I continue my regular antidepressant or therapy while on Spravato®?
A: Yes, in most cases. Spravato® was initially approved to be used in conjunction with an oral antidepressant, and even with the new monotherapy approval, many doctors still recommend that patients stay on their current antidepressant medication at least through the early Spravato® treatment. The Spravato® can provide quick relief, while your oral medication or other treatments provide a stable long-term foundation. Over time, some patients and their doctors may decide to adjust their other meds – for example, if Spravato® works very well, you might be able to simplify your medication regimen under medical guidance. Do not stop or change any of your other medications without consulting our team. In addition, we highly encourage you to continue therapy/counseling if you’re engaged in it. Spravato® often gives people the lift they need to get more out of therapy. Combining medication treatment with psychotherapy is a gold-standard approach in treatment-resistant depression. Our clinic can coordinate with your therapist or even provide therapy referrals if needed. The bottom line: Spravato® is usually one piece of a larger puzzle. We’ll help integrate it with the rest of your mental health strategy for the best outcome.

Q: Do I need a referral to get Spravato® at your clinic?
A: No formal referral is required to inquire about Spravato® at our clinic – you can contact us directly to discuss if it’s right for you. We welcome self-referrals; just give us a call to set up an evaluation. However, in some cases your insurance may require authorization or a referral from your primary care provider or psychiatrist before covering Spravato®. If that’s the case, we will gladly work with your doctors to obtain any necessary documentation. Many patients also come to us through referrals – for example, your therapist or psychiatrist might suggest trying Spravato® and refer you to our program. Either route is fine. The key is that before you start Spravato®, one of our psychiatric providers must evaluate you in person (or via telehealth if appropriate) to confirm you meet the medical criteria and it’s a safe option. This initial consultation can be arranged without a referral; and if paperwork or prior authorization is needed, our staff will assist you step by step. Don’t let the referral question be a barrier – just reach out, and we’ll guide you through the process.

Q: Will my insurance cover Spravato® treatments?
A: In many cases, yes. Most major insurance companies (including Medicare and commercial plans) do cover Spravato® for treatment-resistant depression, but typically they require prior authorization and documentation that you meet the medical criteria. We have experience working with insurers to get Spravato® approved. If you’re eligible for Spravato®, we will start the authorization process on your behalf. Coverage can depend on your specific plan: sometimes Spravato® is covered under your medical benefit (similar to an outpatient procedure), and other times under your pharmacy benefit – we’ll figure out the right billing route. Co-pays and costs also vary: some insurance plans have a co-pay per treatment or per medication. The good news is, Janssen (the manufacturer) offers a patient support program called Spravato® withMe, including a Co-pay Savings Program for eligible commercially insured patients, which can significantly reduce out-of-pocket costs. For example, with the savings program, some patients pay as little as $10 per treatment if they qualify. We will connect you with these resources as appropriate. If you have concerns about cost, let us know – our staff can help estimate your coverage and explore assistance options. Ultimately, we don’t want cost to prevent you from getting this potentially life-changing treatment. We encourage you to call your insurance to ask about Spravato® coverage, and we’ll coordinate with them by providing the required medical information. Before starting treatment, you will know exactly what (if anything) you’ll need to pay. Transparency is important to us.

Q: What is the process to get started, and how do I schedule an appointment?
A: Getting started with Spravato® at our clinic involves a few key steps (see the next section on Scheduling & Consultation for more details). In summary: first, reach out to us – by phone or through our website – to express your interest. We’ll schedule you for an initial evaluation with one of our psychiatric providers. In that visit, we’ll verify if you meet the criteria for Spravato® and discuss the treatment thoroughly. If Spravato® is appropriate and you decide to proceed, we then handle insurance authorization and enrollment in the Spravato® REMS safety program. Once approval is secured (this can take a week or two depending on your insurer), we’ll set up your first treatment session. You’ll also need to arrange a ride for the day of treatment, since you can’t drive afterward. We often have new patient orientation materials to help you prepare for the first session (what to bring, what to expect). Our team will guide you at every step, making the process as smooth as possible. To start, simply contact us – we’ll take it from there and get you on the path to potentially feeling better with Spravato®.

Don’t wait! Call us at 276-247-9669 or book an appointment online at http://www.mindbridgementalhealth.com