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FAQs About Spravato

FAQs About Spravato

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What is Spravato?

Spravato is the brand name for Esketamine. Esketamine is a stronger variation of the anesthetic ketamine, which has been used for many years to treat depression. Esketamine recently received FDA approval for use as a nasal spray for people with Treatment Resistant Depression (TRD).1

Patients with Major Depressive Disorder (MDD) with acute suicidal thoughts or actions who have not improved after taking at least two antidepressants at suitable doses for a sufficient time are considered to have TRD.2

How Does Spravato Work in the Brain?

In contrast to other oral antidepressants already on the market, Spravato functions differently in targeting the N-methyl-D-aspartate (NMDA) receptor.3 Although, it is unclear exactly how Spravato functions.

How Long Does Spravato Last?

Spravato has a considerable mood-lifting effect that can linger for weeks after just one dosage. In the majority of cases, more dosages will be needed regularly. After an initial response to Spravato, antidepressant medication should be continued, according to clinical practice guidelines for major depressive disorder (MDD).

Most agree that treatment should continue for at least six months. However, all of this depends on the patient’s specific needs and tolerance.4

How Long Does Spravato Stay in Your System?

Esketamine concentrations peak 20 to 40 minutes after ingestion. It acts much more quickly than conventional antidepressants.5 Your blood pressure may rise briefly and continue to rise for up to 4 hours. After the first 2-4 hours, Spravato begins leaving your system, but it may take 6–12 hours for it or its metabolites to disappear entirely.6

What is the Difference Between Spravato & TMS?

The various treatment options for certain types of depression have different effects from one person to the next. Therefore, what works for one individual may not necessarily work for another.

The fundamental difference between Spravato and Transcranial Magnetic Stimulation (TMS) is how treatments are administered. Electromagnetic pulses are sent into the brain during TMS therapy to activate the brain cells responsible for mood regulation. As a supplement to an oral antidepressant, intranasal Spravato (Esketamine) is a type of nasal spray. When using Spravato, a qualified psychologist or another medical professional must monitor the medication’s effects during treatment.

How Much Does Spravato Cost?

The price of Spravato can vary, just as with other medications. A specialty pharmacy will supply Spravato to your doctor’s office. You can’t get Spravato at your local drugstore.

The medication alone is expected to run between $590 and $885 per treatment. Because Spravato may only be administered in the doctor’s office under strict supervision, the 2-hour treatment session (about $250) will be added to the drug cost bringing each treatment session to between $840 and $1135.

Unfortunately, expenses can soon mount up. The cost of Spravato treatment, which comprises 32–52 maintenance sessions over a year, can range from $35,000 to $57,000.7

Depending on your policy, your prescription or health insurance plan may compensate for the cost of Spravato’s therapy. Athena Care’s multiple mental health clinics in Tennessee are in-network with most major insurance plans. Filling out our free and confidential online insurance verification form is the easiest and quickest method to determine the specifics of your Spravato coverage.

Can Spravato Be Used for Depression?

At this time, Spravato must be taken in conjunction with an oral antidepressant and is only approved for treating Treatment Resistant Depression (TRD) in adults.

Can Spravato Be Used for Bipolar?

Spravato has not been tested and is not recommended for patients with bipolar disorder.

Can Spravato Be Used for Anxiety?

Anxiety disorders cannot be treated with Spravato. The use of Spravato for this purpose has not been examined in clinical studies. Still, studies may be conducted in the future.

Can Spravato Be Used for OCD?

Obsessive Compulsive Disorder (OCD) cannot be treated with Spravato. The effectiveness of Spravato in treating OCD has not been demonstrated in any clinical investigations. Several clinical studies have examined ketamine, a medication related to Spravato, as a potential OCD treatment.

Can Spravato Be Used for PTSD?

Even though the Spravato medication is now only FDA-approved for the treatment of treatment resistant depression (TRD) in adults, a recent study suggests that it may be able to reduce comorbid PTSD symptoms.8

Can Spravato Be Used for Chronic Pain?

The FDA has not approved Spravato as a pain reliever. However, the chemical interactions that ketamine causes show fantastic potential as an effective treatment.

More research is needed before it can become a widely used treatment for chronic pain caused by illnesses like fibromyalgia. The genuine benefit of ketamine, according to many medical researchers, lies in the insights it can offer in addition to traditional treatments to better educate the medical community about fibromyalgia.9

Can You Overdose on Spravato?

The risk of an overdose is minimal because Spravato is administered in front of medical personnel. In addition, Spravato overdoses have not been documented in any clinical trials.10

Can Spravato Be Used in Elderly Patients?

Esketamine has been used successfully in persons under 65 with Treatment Resistant Depression (TRD).

One hundred thirty-eight patients with TRD, 65 and older, were included in a manufacturer-funded phase 3 trial of esketamine nasal spray. The patients were randomized to receive esketamine or a placebo nasal spray twice weekly for four weeks before beginning treatment with an oral antidepressant (venlafaxine, duloxetine, escitalopram, or sertraline) that had not been taken previously during the current episode.11

Improvement was not statistically superior with Spravato plus an oral antidepressant compared to the control treatment on a standardized scale. However, in subanalyses, those under 74 and those whose depression had started earlier (age at onset, 55) experienced considerably stronger effects from the combined treatment.


  1. “Esketamine for Treatment-Resistant Depression.” Johns Hopkins Medicine, 15 Oct. 2021, www.hopkinsmedicine.org/health/treatment-tests-and-therapies/esketamine-for-treatment-resistant-depression.
  2. Office of the Commissioner. “FDA Approves New Nasal Spray Medication for Treatment-Resistant Depression; Available Only at a Certified Doctor’s Office or Clinic.” U.S. Food and Drug Administration, U.S. Food and Drug Administration, 6 Mar. 2019, www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression-available-only-certified
  3. “SPRAVATO® (Esketamine) | Official Patient Website.” SPRAVATO® (Esketamine), 30 Sept. 2022, www.spravato.com/trd/faqs?
  4. “Dosage and Administration of SPRAVATO – Duration of Therapy.” JanssenMD® Professional Information Resource, 26 July 2022, www.janssenmd.com/spravato/dosage-administration/treatment-duration/dosage-and-administration-of-spravato-duration-of-therapy.
  5. Esketamine (Spravato).” NAMI: National Alliance on Mental Illness. www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Esketamine-(Spravato). Accessed 13 Oct. 2022.
  6. Slowiczek, Lindsay PharmD. Spravato (Esketamine). 10 Dec. 2021, www.medicalnewstoday.com/articles/326038.
  7. “Ketamine Infusion Treatment – Depression, Migraines, Fibromyalgia and Pelvic Pain.” Ketamine Research Institute, 12 Aug. 2022, ketamineinstitute.com/spravato-esketamine-nasal-spray.
  8. “Use of SPRAVATO in Patients With Comorbid Post-Traumatic Stress Disorder (PTSD).” JanssenMD® Professional Information Resource, 26 Apr. 2022, www.janssenmd.com/spravato/clinical-use/comorbidity/ptsd/use-of-spravato-in-patients-with-comorbid-posttraumatic-stress-disorder-ptsd.
  9. “Fibromyalgia | Pain Responds to Ketamine | MI Pain Chicago.” Metropolitan-Institute of Pain, 10 Sept. 2021, mipainchicago.com/fibromyalgia-how-chronic-pain-responds-to-ketamine.
  10. “Overdose of SPRAVATO.” JanssenMD® Professional Information Resource, 7 June 2022, www.janssenmd.com/spravato/safety/overdose/overdose-of-spravato.
  11. NEJM Journal Watch: Summaries of and Commentary on Original Medical and Scientific Articles From Key Medical Journals. 14 Feb. 2020, www.jwatch.org/na50872/2020/02/14/esketamine-nasal-spray-depression-older-patients.

If you suspect that you or someone you love suffers from mental health disorders, contact Athena Care today.

One of our friendly associates will help you get the help you need. Take this first step to feel better and take control. 

(615) 320-1155