Ketamine and Spravato: what clinicians and patients should know

What is Spravato?

Spravato is the brand name for esketamine, a nasal spray with FDA-approved depression indications and specific eligibility requirements. It is administered in a certified healthcare setting under supervision.

A provider reviews treatment history, current symptoms, medical factors, and other care before deciding whether Spravato may be appropriate.

How ketamine infusion differs

Intravenous ketamine is used off-label for depression rather than under an FDA-approved depression indication. Administration, dosing, and follow-up are determined by the treating practice after evaluation.

Coverage and out-of-pocket cost can differ from Spravato. Confirm current details with the office and insurer.

What an in-office treatment involves

Both treatments require supervised administration and monitoring. Temporary effects can include changes in perception, dizziness, nausea, sedation, or increased blood pressure.

Patients need to follow the practice’s transportation and post-treatment safety instructions and should not assume they can drive after a session.

Treatment is part of a broader plan

These treatments are not a replacement for every other form of care. Medication management, therapy, safety planning, and coordination with an established clinician may remain important.

Response varies. Your clinician can help assess whether treatment is appropriate and discuss realistic expectations for your care.

For patients and referring clinicians

Patients and clinicians can contact the office to ask about evaluation, referral information, monitoring, and coordination with ongoing treatment. Immediate suicidal thoughts or a safety emergency require urgent crisis or emergency care rather than a routine referral.