SPRAVATO®

SPRAVATO® (Esketamine) Nasal Spray

About This Innovative Treatment

KetAssure is an approved provider of SPRAVATO® (esketamine) nasal spray, a new treatment option for adults with Treatment-Resistant Depression (TRD) or Major Depressive Disorder (MDD) with acute suicidal ideation or behavior.

FDA Approved: SPRAVATO® is an FDA-approved NMDA receptor antagonist. It is approved for use either alone (monotherapy) or in conjunction with a daily oral antidepressant.

Mechanism of Action: SPRAVATO® works on a different pathway than traditional antidepressants, targeting the brain's glutamate system. This unique mechanism may lead to the formation of new neural connections.

Key Benefit: Patients may experience rapid symptom reduction, with a difference observed as early as 24 hours after the first dose in clinical trials.

Treatment Protocol & Scheduling

Your treatment schedule is standardized and administered under medical supervision at our clinic.

Typical Treatment Phases:

Total Time Commitment: Each treatment session requires approximately 135–145 minutes (about 2.5 hours) from start to finish

Average Duration: Treatment often continues for an average of 4.5 years (though duration is highly individualized and determined by your response).

Phase 1 / Induction

Duration: Weeks 1-2 (Initial 2 weeks)

Frequency: Twice weekly

Phase 2 / Continuation

Duration: Weeks 3-8 (Next 4 weeks)

Frequency: Once weekly

Phase 3/ Maintenance

Duration: Weeks 9 and after

Frequency: Every 2 weeks or once weekly (based on response)

Safety & Administration Requirements (REMS)

SPRAVATO® is a controlled substance and is only available through a strict safety program called the SPRAVATO® REMS (Risk Evaluation and Mitigation Strategy).

In-Clinic Requirements:

Direct Supervision: The medication must be self-administered by the patient under the direct supervision of a certified healthcare provider at our clinic.

Mandatory Monitoring: Patients must be monitored by a healthcare provider for at least two hours after administration for sedation, dissociation, and vital sign changes.

Transportation is Mandatory: Patients should not drive, operate machinery, or engage in other potentially hazardous activities until the next day following a restful sleep. A safe ride home is MANDATORY after every treatment session.

Affordability & Next Steps

Insurance Coverage & Affordability

YES, It’s Covered! SPRAVATO® is generally covered by most major insurance plans, including Blue Cross Blue Shield, United Health, Aetna, and most forms of Medicare.

Prior Authorization: Our skilled team will work with you to secure prior authorization and benefits eligibility, which usually takes around 1–2 weeks. A small copayment may be required.

Is SPRAVATO® Right For You?

To ensure safety and proper fit, we require a thorough review of your medical history.

Referral & Documentation: Most insurance companies require a referral from your PCP and/or a Letter of Medical Necessity from your psychiatric provider.

Contraindications: SPRAVATO® is not appropriate if you have: