What is SPRAVATO?
Spravato® (esketamine nasal spray) is an FDA-approved treatment designed for individuals with treatment-resistant depression (TRD) or major depressive disorder (MDD) with suicidal thoughts or actions. Unlike traditional oral antidepressants, Spravato® targets glutamate pathways in the brain, providing a different approach to treating depression symptoms.
For individuals who have tried two or more oral antidepressants without significant relief, Spravato treatment offers a new evidence-based solution. Clinical studies have shown that Spravato® nasal spray, when used alongside an oral antidepressant, can provide rapid and lasting symptom relief for patients struggling with treatment-resistant depression.
How Spravato® Works
Traditional oral antidepressants primarily work by increasing levels of serotonin, dopamine, and norepinephrine. Spravato®, on the other hand, acts on the glutamate system, a different neurotransmitter pathway associated with mood regulation and cognitive function. By targeting glutamate, Spravato® helps restore balance in brain function, leading to a significant reduction in depressive symptoms.
Key Benefits of Spravato® Treatment:
- Provides relief from treatment-resistant depression (TRD)
- Offers rapid symptom reduction, with improvements often seen within 24 hours
- Works alongside an oral antidepressant for a comprehensive treatment approach
- Reduces suicidal ideation in individuals with severe depression
Who Is Eligible for Spravato?
Spravato® is recommended for individuals who:
- Have been diagnosed with treatment-resistant depression (TRD)
- Have major depressive disorder (MDD) with suicidal thoughts or behavior
- Have not responded to at least two oral antidepressants
- Are currently under the care of a healthcare provider specializing in mental health
Because Spravato® is not a standalone treatment, it is always used in combination with an oral antidepressant to enhance effectiveness.


What to Expect During Spravato Treatment
Spravato® treatment is administered under medical supervision in a certified healthcare setting, such as Apogee Behavioral Medicine. Patients self-administer the Spravato® nasal spray while being closely monitored by a healthcare provider.
Treatment schedule:
- Induction Phase: Spravato® is taken twice a week for the first four weeks
- Maintenance Phase: After the initial phase, treatments gradually decrease to once a week or every two weeks based on patient response
Each treatment session lasts about two hours as patients are monitored for potential side effects before leaving the medical facility.
Effectiveness of Spravato®: Clinical Studies and Results
Several clinical studies have demonstrated the effectiveness of Spravato® for individuals with treatment-resistant depression.
Short-Term Study Results:
- Patients taking Spravato® alongside an oral antidepressant showed greater symptom reduction at four weeks compared to those taking a placebo spray plus an oral antidepressant.
- Most symptom relief was observed within 24 hours after the first dose.
Long-Term Study Results:
- Patients who continued using Spravato® and an oral antidepressant had a lower risk of relapse compared to those who discontinued treatment.
- Ongoing maintenance treatment helped patients sustain improvements in depressive symptoms over time.
How Much Does Spravato® Cost?
The cost of Spravato treatment depends on insurance coverage and treatment duration. Many insurance providers, including Medicare and private plans, may cover part or all of the treatment. Our team at Apogee Behavioral Medicine will assist with insurance verification and explore financial assistance programs for eligible patients. Factors that influence cost:
- Insurance coverage and plan details
- Number of treatments required for symptom relief
- Co-pays or deductibles based on individual healthcare plans
For detailed pricing and coverage information, contact Apogee Behavioral Medicine for a consultation.


Potential Side Effects and Safety Considerations
To ensure patient safety, Spravato® is only available through a restricted program called the Risk Evaluation and Mitigation Strategy (REMS). Patients must receive treatment at a certified medical facility, such as Apogee Behavioral Medicine, where they can be closely monitored for any potential risks.
As with any medical treatment, Spravato® comes with potential side effects. Patients are monitored for serious adverse outcomes, and treatment is provided within a restricted program under healthcare supervision. Common side effects of Spravato® treatment:
- Dizziness, nausea, vomiting, and headache
- Increased blood pressure (high blood pressure monitoring required)
- Feeling drunk, disoriented, or disconnected from surroundings
- Respiratory depression (breathing problems) in some patients
- Possible chest pain or irregular heartbeat
Because of these possible effects, patients should not operate machinery or drive on the day of Spravato® treatment.
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Why Choose Apogee Behavioral Medicine for Spravato® Treatment?
At Apogee Behavioral Medicine, we are dedicated to helping patients overcome treatment-resistant depression through evidence-based solutions like Spravato®. With nine clinics across North Carolina, we provide expert psychiatric care in a safe, supportive environment.
What Sets Apogee Behavioral Medicine Apart?
If you or a loved one is struggling with treatment-resistant depression, Spravato® treatment at Apogee Behavioral Medicine may provide the breakthrough relief you need.
- Board-certified healthcare providers experienced in administering Spravato®
- In-network with most major insurance providers for accessible treatment options
- Personalized treatment plans tailored to individual needs
- State-of-the-art medical offices designed for patient comfort and safety
How to Get Started with Spravato® Treatment
If you have tried two or more oral antidepressants and still experience depression symptoms, it may be time to explore Spravato® as a treatment option. Our team at Apogee Behavioral Medicine will guide you through the treatment process, from evaluation to ongoing support. Don’t wait—relief from treatment-resistant depression is within reach. Contact Apogee Behavioral Medicine today to find out if Spravato® is right for you.
Call (855) 409-9002 or schedule a consultation online to discuss your options for Spravato treatment in North Carolina.
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What Our Patients Say
My experience with Apogee Behavioral Medicine has been amazing! The providers and office staff are so friendly and helpful and demonstrate a true sense of care. I appreciate that every time I call there is always a kind person on the other end of the phone. From scheduling, to my actual appointment with Dr. Ayers, they have made the entire process as straightforward and easy as possible. I prefer to be seen in-person, but travel for work so it’s comforting to know I have the option to book a virtual appointment, if needed. I’m so grateful for the compassion they have shown me and look forward to their guidance as I learn to manage my anxiety. I feel like I’ve finally found the support system I’ve been searching for.
I reached out to several psychiatry groups, some of which never even returned my call. Not only was I able to speak with an actual person, but she scheduled me for an appointment right away. Their office has a very calming feel and I was greeted with a smile and felt safe and welcomed at my appointment. I highly recommend Apogee Behavioral Medicine. They’re truly a wonderful group and their sincerity for patients dealing with mental health is at the forefront of this practice.
It was very easy to talk to the professionals there. They listened to everything I said and were very encouraging and supportive. I highly recommend Apogee Behavioral Medicine to anyone.