Spravato (Esketamine) Nasal Spray Clinics

How Spravato (Esketamine) Nasal Spray Works

Spravato is the brand name for esketamine, an FDA-approved nasal spray for treatment-resistant depression and for depressive symptoms in adults with major depressive disorder with suicidal thoughts or actions. Because it carries risks of sedation and dissociation, it can only be administered in healthcare settings certified under the FDA's REMS safety program — patients self-administer the spray in the office and are monitored for two hours.

Because Spravato is FDA-approved, it is the ketamine-class treatment most often covered by commercial insurance and Medicare, usually alongside an oral antidepressant. Treatment starts twice weekly for a month, then steps down to weekly or every-other-week maintenance. Clinics in this directory that appear in the official Spravato REMS locator as actively treating centers display a certification badge on their listing.

What to Expect at Your Appointment

Each visit: a pre-dose blood-pressure check, self-administering the nasal spray under supervision, then a mandatory two-hour monitored rest period before discharge with a driver. Most patients describe lighter dissociative effects than IV ketamine.