Spravato (Esketamine) Treatment for Treatment-Resistant Depression
If depression hasn’t improved with other treatments, Spravato® may offer a different path forward. iMind is a REMS-certified Spravato treatment center serving Port St. Lucie, Stuart, and Vero Beach, with evening and weekend appointments available at our Port St. Lucie office.
- FDA-approved nasal spray for treatment-resistant depression
- REMS-certified Spravato treatment center
- Taken and monitored in our office
What Is Spravato?
Spravato (esketamine) is a prescription nasal spray approved by the FDA for adults with treatment-resistant depression and for adults with major depressive disorder who are experiencing acute suicidal thoughts. It was developed by Janssen Pharmaceuticals and first approved in 2019.
Spravato works differently from oral antidepressants, and for some people it works faster, with improvement noticed within hours to days rather than weeks. Because of how it is taken and monitored, Spravato is only available at certified treatment centers and cannot be prescribed for use at home. iMind is a REMS-certified Spravato treatment center, which means we meet the FDA’s requirements to offer it in our offices.
How Does Spravato Work?
Most oral antidepressants act on serotonin and norepinephrine. Spravato works on a different pathway: the glutamate system. Glutamate is one of the brain’s most abundant chemical messengers, and it plays a central role in how brain cells communicate and adapt. Spravato blocks a glutamate receptor called the NMDA receptor, which is thought to help nerve cells form new connections.
Because it works through a different pathway, Spravato can help when other medications have not. Researchers believe this may also be why some people notice relief sooner than they would with a traditional antidepressant. You take the nasal spray yourself in our office while our clinical staff observes, and the medication never goes home with you.
Spravato has been shown to work in several studies. With antidepressants alone, many people with depression never get full relief from their symptoms. Spravato can be a godsend for these treatment-resistant patients.
Justin Baksh, LMHC, BC-TMH, Chief Clinical Officer, iMind Mental Health Solutions
What Is a Spravato REMS Treatment Center?
- Be certified to receive and treat patients with Spravato
- Confirm that each patient is enrolled in the REMS program by a Spravato prescriber
- Directly observe and monitor every patient for at least two hours after treatment
- Report to the manufacturer’s REMS program on a timely basis
iMind is a REMS-certified Spravato treatment center serving Port St. Lucie, Stuart, and Vero Beach.
Who Qualifies for Spravato?
If you’ve tried several antidepressants and still feel stuck, it isn’t a reflection of anything you’ve done wrong. Depression that doesn’t respond to standard medication, often called treatment-resistant depression, is common, and Spravato was developed for exactly this situation.
Spravato is FDA-approved for two groups of adults:
- Adults with treatment-resistant depression, meaning depression that hasn’t improved after at least two adequate antidepressant trials
- Adults with major depressive disorder who are experiencing acute suicidal thoughts
To find out whether you qualify, start with an evaluation at iMind. We review your medication history and current symptoms to determine whether Spravato is appropriate for you, and if you move forward, we enroll you in the REMS program before your first dose.
What to Expect During Spravato Treatment at iMind
Spravato treatment takes place entirely in our office. Here is how each step works.
- Before treatment: You complete an evaluation, we verify your insurance and handle prior authorization, and you are enrolled in the REMS program.
- Your session: You take the nasal spray yourself under the supervision of a certified provider, then you are monitored in our office for at least two hours.
- Getting home: Plan for someone else to drive you home. You should not drive until the next day, after a restful night of sleep.
Most people start with twice-weekly sessions for four weeks, move to weekly sessions for the next four weeks, and then continue every one to two weeks for maintenance. Your provider adjusts the schedule to how you are doing.
Brain Mapping at iMind: We Don’t Guess, We Verify
Spravato treatment at iMind is guided by evidence, not guesswork. We use brain mapping, a noninvasive scan that creates a visual map of your brain’s activity, to guide and verify your care:
- Before treatment: A baseline scan helps confirm whether Spravato is the right fit and gives us a starting point to measure against
- During treatment: Follow-up scans show how your brain is responding, so your provider can adjust your plan
- As you improve: A later scan helps verify your results, so you can see the change for yourself
Depression can make it hard to tell whether you’re getting better. Seeing your progress on a scan gives you and your provider something concrete to go on.
How Effective Is Spravato?
Does Spravato really work for depression? For many people with treatment-resistant depression who haven’t found relief with other medications, it does. Some people notice a difference within hours to days of their first treatment, although the timing varies from person to person. Others take several sessions, which is why your provider checks in on your progress throughout the first weeks of treatment.
Ongoing maintenance treatment is typically needed to sustain results, so most people continue at a regular interval rather than stopping after the first month. Your provider will talk with you about what that looks like as you improve.
What Our Patients Say
Shannon
Spravato Side Effects
The most common side effects of Spravato are dissociation (a feeling of being disconnected from yourself or your surroundings), dizziness, nausea, and sleepiness. They usually begin shortly after the dose, and most ease within the two-hour monitoring window. Our team also checks your blood pressure before and after each dose, since Spravato can raise it temporarily.
That monitoring window is why Spravato is only available at certified treatment centers. Every patient is observed by trained clinical staff, so any effect is managed in the moment. Serious risks are rare, and the potential for misuse is the reason Spravato cannot be taken at home.
The side effects are real, but they are manageable and temporary, and knowing what to expect makes the experience far less intimidating.
Does Insurance Cover Spravato?
Many insurance plans cover Spravato for treatment-resistant depression, including Medicare. Most plans require prior authorization, and iMind handles that process for you. Before treatment begins, we evaluate whether Spravato is appropriate for you, verify your benefits, and let you know what to expect.
Without insurance, Spravato can be costly, and the price varies by dose and schedule. If your plan doesn’t cover Spravato, our team can talk with you about payment options. For copays and deductibles, we accept credit cards and HSA payments.
Why Choose iMind as Your Spravato Treatment Center
Not every practice can offer Spravato. All three of our offices are REMS-certified, every patient begins with an individual evaluation with our clinical team, and we use brain mapping to guide and verify treatment. You can receive Spravato treatment at any of our three Florida offices:
- Port St. Lucie (evening and weekend appointments available)
- Stuart
- Vero Beach
Spravato is one option among several. If it isn’t the right fit, our team also offers TMS therapy at iMind, a noninvasive treatment for depression that hasn’t responded to medication.
Mental Health Resources
Start Spravato Treatment at iMind
You don’t have to keep waiting for depression to lift on its own. Schedule a consultation and our team will help you decide whether Spravato is the right next step. Most appointments are available within 48 hours, or you can call us at (772) 257-4523.
