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SPRAVATO® (esketamine)

SPRAVATO®, an innovative treatment option offered by Cognizant Behavioral Health Services (CBHS), is a prescription nasal spray that contains esketamine. This fast-acting, FDA-approved medication can help adults with treatment-resistant depression find relief when other methods have not worked. If you choose to receive Spravato at CBHS, you will receive expert care in a safe, supportive environment designed to help you regain control of your life.

What to expect from SPRAVATO?

How Spravato Works:

Unlike traditional antidepressants that target serotonin or norepinephrine, Spravato acts on the brain’s glutamate system. This unique mechanism allows it to provide more rapid relief for individuals who have not responded to other medications, making it especially suitable for those with treatment-resistant depression.

Who Can Benefit from Spravato

Spravato is designed for adults with treatment-resistant depression and may also be used for major depressive disorder with suicidal thoughts. You may benefit from Spravato if you have tried multiple medications without significant improvement in your symptoms.

If you meet the criteria, our CBHS team will conduct a thorough diagnostic evaluation to determine whether Spravato is the right fit for you. You will receive a customized treatment plan, and we will support you every step of the way. Many adults begin to notice changes within just weeks of starting Spravato—experiencing greater clarity, improved mood, and reduced emotional weight.

What to Expect During Treatment:

Your Spravato treatment will begin with a detailed consultation and assessment by our team. Once approved for Spravato, you will visit CBHS twice a week during the initial phase of treatment. At each session, you will self-administer the nasal spray in a comfortable clinical setting. Afterward, you will be observed for approximately two hours to monitor for any side effects. The CBHS team will ensure you feel supported and safe throughout the process.

Over time, the frequency of sessions may be reduced based on your progress and how well your body responds. You will also have regular check-ins with your clinician so that your plan can be adjusted as needed. This level of personalized care helps maximize the effectiveness of Spravato and allows you to move forward with confidence.

FAQ

Most frequent questions and answers

Each visit takes about two hours. You will self-administer your Spravato dose in the office with the guidance of our team. Afterward, you’ll stay for a two-hour monitoring period so we can check your blood pressure, oxygen levels, and watch for any potential symptoms or side effects. You’ll need someone to drive you home after each session.

You’ll be in a calm, comfortable setting. You’re welcome to rest, relax, or listen to music. We recommend bringing headphones and choosing instrumental or word-free music to avoid overstimulation. Blankets are available to help you feel more at ease. Our team will check in regularly to ensure your safety and comfort.

Common temporary side effects may include:

  • Sedation
  • Increased blood pressure
  • Feelings of dissociation (e.g., feeling strange or disconnected, or changes in sense of time)

These effects typically occur within the first two hours, which is why you’ll remain under supervision during that time.

  • First 4 weeks: Twice per week (approx. 2 hours per visit)
  • Second month: Once per week
  • Ongoing: Once per week or twice per month, depending on your progress and clinician’s recommendations
No. The FDA prohibits at-home use due to the potential risk of misuse and addiction. Spravato must be administered in a certified medical office under professional supervision.

Spravato may not be appropriate for:

  • Individuals under the age of 18
  • Those with uncontrolled high blood pressure
  • A history of substance use disorder involving ketamine or esketamine
  • Brain aneurysms
  • Hemorrhagic strokes
  • Active or uncontrolled psychosis
  • Pregnant or lactating women