Spravato
Treatment
for Depression
You have questions.
We have answers.
You have questions.
We have answers.
Welcome to our Spravato FAQ page, where we draw upon our unparalleled experience to answer your most pressing questions. As pioneers in Spravato therapy with over 10,000 administered treatments and hundreds of success stories, we've encountered virtually every scenario and question imaginable.
Our team has helped patients navigate the complexities of treatment-resistant depression, guiding them through the Spravato journey with expertise and compassion. From insurance coverage to side effect management, from treatment protocols to long-term outcomes, we've compiled the answers to the questions we hear most often.
Our responses, below, are grounded not just in clinical knowledge, but in real-world experience and the countless patient interactions that have shaped our approach. Whether you're considering Spravato for the first time or looking to deepen your understanding, you'll find clear, trustworthy information here, backed by our extensive hands-on expertise.
SPRAVATO™ is taken with a daily oral antidepressant - Patient Brochure
You administer SPRAVATO™ nasal spray yourself under the supervision of a healthcare professional at a certified SPRAVATO™ treatment center
SPRAVATO™ is taken twice a week for the first four weeks
After the first four weeks, SPRAVATO™ is taken once a week for a month
After this, SPRAVATO™ is usually taken either once a week or once every two weeks
Most major insurances (Aetna, Cigna, Horizon, United, Medicare, Medicaid) cover SPRAVATO™ treatments. Additionally, various support programs from Janssen Pharmaceuticals help patients cover the costs of medication and of administration/observation. Learn more about this topic on our Spravato Cost & Insurance Page
No, administered at small doses in a medical setting, there is no evidence that Spravato is addictive (study). In contrast, those who abuse this medication recreationally do so at very high doses to induce psycho-active affects.
No, clinical experience suggests that Spravato is especially effective for patients with treatment-resistant depression, including those who have already tried ECT and/or TMS without benefit. In fact, literature suggests that the patients MOST resistant to other treatments tend to have the greatest response to Spravato (Research article)!
In clinical studies, improvement of depressive symptoms was demonstrated at four weeks by SPRAVATO® plus an oral antidepressant (study), compared with placebo nasal spray plus an oral antidepressant. Not all patients will respond to SPRAVATO®. Many patients respond as early as after the first treatment, while others see major improvements after a few months of treatment. Our experience has been that almost everyone leaves their first Spravato session more relaxed and less pessimistic about the future!
Some (very few) patients taking SPRAVATO® may experience nausea or vomiting. Because of this, you should avoid eating two hours before, and drinking liquids 30 minutes before, taking SPRAVATO®.
Studies suggest that once improvement is seen, it is sustained over time! (Research Article)
The current recommended treatment protocol is for 2x a week treatment for the 1st 4 weeks, then weekly treatments weeks 5-9. Thereafter, treatment frequency is once every 1-2 weeks. There are now studies demonstrating efficacy of Spravato for over 4 years!
Although it is given as an intranasal spray, the FDA has highly regulated Spravato. The FDA has also required that Spravato be administered in the practitioner’s office with a 2 hour post-application monitoring period in the office.
According to the latest depression therapy medical studies, depression doctors have found that the success rate or efficacy of Spravato (esketamine) depression treatments varies, but several key points are as follows:
- In clinical trials by the manufacturer Janssen Pharmaceuticals, after 16 weeks of Spravato treatment along with an oral antidepressant, patients were less likely to have a return of depressive symptoms compared to those who stopped taking Spravato.
- At 4 weeks, 52.5% of patients receiving Spravato plus an oral antidepressant achieved remission, compared to 31% with placebo plus oral antidepressant.
- At 32 weeks, 55.7% of Spravato plus oral antidepressant patients were in remission, compared to 36.3% taking quetiapine extended-release plus oral antidepressant.
- 75.9% of patients treated with Spravato plus oral antidepressant achieved response, compared to 55% with quetiapine extended-release plus oral antidepressant.
- The depression treatment efficacy appears to increase with longer treatment duration.
Another study found that 65% of participants achieved a 50% or greater decrease in depression scores after 74 days of Spravato treatment.
So in summary, the success rates from the provided sources range from around 52-76% achieving remission or response when Spravato is combined with an oral antidepressant over 4-32 weeks of treatment, compared to lower rates with placebo or other medications.
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