Esketamine Treatment (Spravato) | Advanced Psychiatric Therapeutics Clinic | Psychiatry and Behavioral Health |UC Davis Health

Esketamine (brand name Spravato®) is approved by the U.S. Food and Drug Administration (FDA) as an antidepressant medication that is administered as a nasal spray.

The active ingredient in Spravato® is esketamine hydrochloride. This is one of two molecules that makes up ketamine, an anesthetic agent that has been found to have rapid-acting antidepressant effects.

Spravato® is FDA-approved to treat adults with Major Depressive Disorder who have not responded to two or more antidepressant medications, or who are experiencing suicidal thoughts. Spravato® is to be used in combination with an oral antidepressant medication.

How is eskatamine different than other antidepressant medications?
Spravato® is the first antidepressant approved in decades that works differently than other antidepressant medications. Spravato® affects the glutamate system in the brain, while most antidepressants affect serotonin or norepinephrine. Spravato® can help even when other antidepressants have not. For some people, Spravato® works more rapidly than other antidepressants.

What can I expect with treatment?
Due to the potential for serious side effects, including dissociation and sedation, Spravato® is administered in a health care setting. After each dose of Spravato®, patients must be monitored in clinic for two hours. Patients are not permitted to drive after treatment and will need to arrange transportation home from clinic.

Is it safe?
Spravato® has been approved by the U.S. Food and Drug Administration and is generally safe when administered in a health care setting. Patients are monitored for two hours after each dose because Spravato® has the potential to cause serious side effects for several hours following administration, including sedation (drowsiness), dissociation (feeling disconnected from your thoughts, feelings, or body; feeling disconnected from space or time), or increased blood pressure. You should also know that Spravato® has the potential for dependence, misuse, or addiction.

Is it covered by insurance?
Most major insurance plans cover Spravato® for adults with Major Depressive Disorder who have not responded to standard treatments. Each insurance plan has its own criteria. Our clinic staff will help determine whether your treatment is covered by insurance.

Am I a good candidate?
If you are over the age of 18 and suffer from Major Depressive Disorder that has not responded to standard treatments, you may be a good candidate for esketamine therapy.