When traditional antidepressants haven't worked and you're searching for a faster path to relief, there's a breakthrough treatment gaining recognition nationwide: Spravato (esketamine) nasal spray.
Unlike conventional antidepressants that may take weeks to work, Spravato often produces noticeable improvement within hours or days—offering genuine hope to people with severe, treatment-resistant depression. At Elevate Psychiatry in Florida, we specialize in Spravato treatment for patients who haven't found adequate relief through standard approaches.
Spravato is the FDA-approved nasal spray form of esketamine—a medication that works fundamentally differently from traditional antidepressants. FDA approved in 2019 for treatment-resistant depression, it contains esketamine, the active component of ketamine in nasal spray form. It's fast-acting, often producing improvement within hours compared to weeks for standard antidepressants, and is administered in a medical setting under professional supervision.
Spravato represents a paradigm shift in depression treatment. Rather than waiting weeks for medication levels to build in your system, Spravato works rapidly by engaging your brain's neurobiology in novel ways.
Traditional antidepressants increase serotonin availability between neurons and build up gradually over weeks. Spravato takes a completely different approach. It blocks NMDA receptors involved in pain and depression, increases glutamate (the brain's primary excitatory neurotransmitter), and promotes neuroplasticity—the brain's ability to create new connections.
This novel mechanism is why Spravato works for people where multiple SSRIs and SNRIs have failed. Research shows that Spravato actually promotes the growth of new neural connections—literally rewiring the brain circuits that maintain depression.
Spravato is specifically designed for those with treatment-resistant depression (TRD)—meaning you've experienced inadequate relief despite two or more adequate trials of antidepressants at therapeutic doses for adequate duration (typically 4-6 weeks at full dose).
You may benefit from Spravato if you have major depressive disorder diagnosed by a mental health professional, significant symptoms impacting daily functioning, failed trials of at least two standard antidepressants, and willingness to attend treatment sessions in our clinic.
Spravato isn't appropriate if you have uncontrolled high blood pressure, active substance use disorder, psychosis, or are pregnant. During your initial evaluation at Elevate Psychiatry, we'll review your medical history to ensure Spravato is safe and appropriate for you.
While both work through similar mechanisms, there are important distinctions. Ketamine is administered intravenously, used off-label for depression, and requires varying clinical protocols. Spravato is FDA-approved specifically for depression, delivered as a non-invasive nasal spray with standardized dosing, administered in certified clinics, and covered by most insurance plans. For patients seeking the professional, regulated, insurance-covered option, Spravato is the clear choice.
Before starting Spravato, you'll have a comprehensive psychiatric evaluation including depression history review, medical evaluation, medication review, substance use screening, and psychosocial assessment. We'll explain the mechanism, set expectations, and discuss the commitment required.
Each Spravato session takes approximately 2-2.5 hours. You'll start with a vital signs check and symptom assessment, then self-administer the nasal spray under our guidance. During the 1.5-2 hour observation period, you may feel drowsy, dissociated, or emotionally lightened—this is normal and temporary. Our clinical staff monitors you throughout. You'll need someone to drive you home, as you cannot drive for 5 hours after treatment.
The induction phase involves twice-weekly sessions for 4 weeks, then weekly for an additional 4 weeks (typically 12 sessions over 8 weeks). After induction, maintenance sessions occur once weekly then every 2 weeks. Some patients feel improvement within hours of the first dose. Most notice meaningful change by the 3rd-4th session. About 70% of treatment-resistant patients respond significantly.
Spravato is covered by most major insurance plans including Medicare, BlueCross BlueShield, UnitedHealthcare, Aetna, and Cigna. Coverage typically requires prior authorization with documented failures of at least 2 antidepressants and a psychiatric evaluation. Without insurance, sessions range from $500-$800 each. Insurance verification is free at Elevate Psychiatry—we'll determine your coverage before you start treatment.
Spravato is well-tolerated compared to many treatments. Common mild side effects include nausea (10-30% of patients, usually mild), dissociation (expected and temporary), dizziness, nasal irritation, and occasional headache. More serious but rare side effects like elevated blood pressure are monitored during your session. Side effects typically decrease with each session.
At Elevate Psychiatry, we believe in comprehensive care. Spravato works best when combined with your current antidepressant, psychotherapy (especially CBT), lifestyle changes like regular exercise and sleep hygiene, and can even be combined with TMS therapy for treatment-resistant cases.
No. Spravato is esketamine, one component of ketamine, formulated as a standardized nasal spray for psychiatric treatment. It's FDA-approved, dispensed by healthcare professionals, and administered in a controlled medical setting—fundamentally different from unregulated substances.
Spravato produces a dissociative state—feeling detached or "floaty"—which is temporary and expected. Most people don't describe it as a "high." The dissociation disappears within 1-2 hours and you return to your normal mental state.
For many people, Spravato produces lasting improvement with maintenance treatment. Some maintain remission indefinitely with monthly sessions. The goal is finding the minimum frequency needed to keep you well.
Spravato is a controlled substance, but when used as prescribed under medical supervision, addiction risk is low. Our REMS-certified protocol includes safeguards to minimize abuse potential.
At Elevate Psychiatry, we offer board-certified psychiatrists specializing in treatment-resistant depression, a REMS-certified clinic meeting all FDA safety requirements, comprehensive evaluation, experienced clinical staff, an integrated approach combining Spravato with therapy and lifestyle support, insurance expertise, multiple Florida locations for convenient access, and compassionate, patient-centered care.
You don't have to live with treatment-resistant depression. Spravato has helped thousands of people find relief when nothing else worked. If you've tried multiple antidepressants without adequate results, Spravato might be your breakthrough.
Schedule Your Spravato Evaluation at Elevate Psychiatry — Our psychiatrists are ready to determine if you're a candidate for this life-changing treatment. Call us at (305) 908-1115 to speak with our team, or visit one of our Florida locations.
Elevate Psychiatry is a certified Spravato treatment center in Miami, offering this breakthrough therapy under expert medical supervision. Our Miami psychiatrists also provide TMS therapy, medication management, and talk therapy to create comprehensive treatment plans for depression and other conditions.
Visit us at our Coconut Grove or Doral offices, or schedule a telepsychiatry appointment from anywhere in Florida. Contact us today to find out if Spravato is right for you.
