Spravato® (esketamine)

What is Spravato nasal spray? 

Spravato is a prescription medication that treats treatment resistant depression when prior medicines have not been effective. It can also be used by people who experience significant side effects from traditional antidepressants. Spravato also works more quickly than other antidepressants.


What is esketamine? 

Esketamine is the active ingredient in Spravato.  Esketamine is created from an older medication called ketamine.  Esketamine is stronger than ketamine which allows a lower dose to produce beneficial effects.

How can I get Spravato or esketamine in Austin, Texas? 

Spravato must be given at a Spravato-approved provider’s office under supervision.  After evaluation for Spravato by the provider, a prescription will be sent to a Spravato-qualified pharmacy.  The pharmacy will send the medication to the provider’s office for administration.  Spravato requires an observation period after administration, so plan to spend approximately two hours for observation in your appointment.

What is the difference between Spravato and esketamine? 

Spravato is the brand name for esketamine.  Esketamine is the chemical name for the active ingredient in Spravato.

How does Spravato work? 

Spravato works by increasing the amount and effects of dopamine in the brain.  Dopamine aids in improving depression symptoms.

How long does Spravato last? 

Many people experience a decrease in depression within a day of treatment.  Because everyone’s body chemistry is different, the treatment regimen may vary.  Initially, treatments are given several times a week, then people may be tapered to less frequent visits.

When will Spravato be available? 

Spravato is available by appointment now.  It was approved in the US for treatment of depression in 2019, and in 2020, it was also approved for major depressive disorder with suicidal thoughts.

Who makes Spravato? 

Janssen Pharmaceuticals is the only FDA-approved manufacturer of Spravato in the US.

How is Spravato administered?

Spravato is administered as a nasal spray.

How to bill insurance for Spravato? 

Most prescription insurances cover Spravato.  Some insurances require medical billing for the medication.  Your pharmacy customer support on your insurance card can answer coverage questions for Spravato.  If you do not have insurance or if you have a copay on your insurance, Janssen Pharmaceuticals offers financial support for Spravato therapy.

Who can administer Spravato? 

Only healthcare providers that have been through Spravato certification and training may administer Spravato. At this time, Spravato is not approved for patient administration.


Medically reviewed by:

Charles Sweet, MD, MPH

Dr. Sweet is a native Texan and attended The University of Texas at Austin for undergraduate studies. He earned his Doctor of Medicine and Master of Public Health degrees at the University of Illinois and then did residency training at the prestigious Johns Hopkins Hospital, Dr. Sweet came back to Austin, TX for specialized training in Child and Adolescent Psychiatry and has been in practice since 2009.

Dr. Sweet believes strongly in working with, and training Physician Assistants to treat the behavioral health needs of adults, children and adolescents.

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