At Head Well Integrative Psychiatry & Wellness, we meet many individuals who have tried multiple antidepressants without meaningful relief. Spravato® (esketamine) offers another treatment option for adults with treatment-resistant depression, backed by clinical research, delivered with medical oversight, and supported by our integrative approach.
Understanding Treatment‑Resistant Depression
Depression is one of the most common and challenging mental health conditions. While traditional antidepressants help many people, some do not experience adequate improvement after trying multiple treatments. When depression has not responded adequately to appropriate antidepressant treatment, it may be considered treatment-resistant depression (TRD).
For these individuals, Spravato offers a different mechanism of action from conventional antidepressants and may be another treatment option to consider.
What Is Spravato® (Esketamine)?
Spravato is an FDA‑approved nasal spray derived from ketamine, a medication long used safely in anesthesia and now recognized for its rapid antidepressant effects. Unlike traditional antidepressants, which target serotonin or norepinephrine, Spravato acts on the glutamate system to enhance neuroplasticity, the brain’s ability to form new connections and pathways.
How Spravato Works
- Different Mechanism: Spravato acts on the glutamate system through NMDA receptor antagonism, distinguishing it from many conventional antidepressants.
- Individual Response: Some clients may notice changes earlier in treatment, while others may need more time before they and their clinician can determine whether treatment is helping. Response varies from person to person.
- Ongoing Treatment: Your clinical team monitors your response over time and determines whether continued treatment is appropriate based on your individual progress and needs.
What to Expect During Treatment
1. Comprehensive Evaluation
Before beginning Spravato, our clinicians complete a detailed assessment of your medical and psychiatric history to determine whether treatment may be safe and appropriate for you.
2. In‑Clinic Administration
Spravato is administered twice weekly during the initial phase, then gradually reduced. Each treatment takes place in a calm, monitored setting at Head Well.
• You’ll self‑administer the nasal spray under supervision of a healthcare professional.
• Sessions last about two hours, including observation and recovery time.
• You’ll need a trusted adult to drive you home afterward.
3. Ongoing Support
Our team integrates Spravato treatment with psychotherapy, functional medicine strategies, and wellness planning to support your whole‑person recovery.
Potential Benefits of Spravato Therapy
- FDA-approved for treatment-resistant depression in adults
- A different mechanism of action from many conventional antidepressants
- Administered in a certified healthcare setting with required monitoring
- May be covered by insurance when plan requirements and clinical criteria are met
- Can be incorporated into a broader psychiatric treatment plan
Potential Side Effects
Spravato can cause side effects including sedation, dissociation, dizziness, nausea, increased blood pressure, and changes in perception. Respiratory depression and the potential for abuse or misuse are also recognized risks.
Because of these risks, Spravato must be administered in a certified healthcare setting. Our clinical team monitors clients for at least two hours after each treatment and assesses when they are ready to leave the clinic.
Integrative Support for Long‑Term Healing
At Head Well, we view Spravato as one tool within a broader framework of healing. By combining this therapy with functional medicine, nutritional support, and mind‑body practices, we help clients strengthen their resilience and well‑being from the inside out.
Our goal isn’t just symptom relief—it’s to help you thrive.
Frequently Asked Questions
How is Spravato different from IV ketamine?
Spravato® (esketamine) and ketamine therapy share the same scientific foundation but differ in how they’re used and delivered. Spravato is an FDA-approved nasal spray for treatment-resistant depression and depression with suicidal thoughts, taken in clinic under observation and often covered by insurance. Ketamine therapy, by contrast, uses racemic ketamine (both molecular forms) delivered intravenously or intramuscularly. Though used off-label, it’s well supported by research and offers greater flexibility in dosing and integration with psychotherapy.
Will my insurance cover Spravato?
Many insurance plans provide coverage for Spravato when their clinical and authorization requirements are met, but coverage varies by insurer and individual plan.
Our team can help you verify benefits and understand any prior authorization requirements that may apply.
Can I continue my current antidepressant?
Yes. Spravato is typically used in combination with your existing oral antidepressant.
It is also approved for use as monotherapy, or without an oral antidepressant.
Take the Next Step: Wellness Is Within
If you’ve tried other treatments without enough improvement, Spravato may be another option worth discussing with your care team. At Head Well Integrative Psychiatry & Wellness, our team provides medically supervised treatment within an individualized approach to psychiatric care.
Schedule your consultation today. Wellness is within.