--- title: Spravato® Treatment date: 2023-01-31T22:08:09Z modified: 2026-10-15T19:17:30Z permalink: "https://www.columbiapsychiatry-dc.com/mental-health-services/spravato-treatment-program/" type: page status: publish excerpt: The first nasal spray approved by the FDA for treating adults with treatment-resistant depression. wpid: 216 featured_image: "https://www.columbiapsychiatry-dc.com/wp-content/uploads/2025/01/Columbia-Spravato.jpeg" timestamp: 2026-10-15T19:17:30Z tags: [] --- ## Relief from Treatment Resistant Depression Symptoms Is Possible with Spravato® Spravato®, also known as esketamine, is a fast-acting treatment, with clients often feeling relief from their depression symptoms within hours. It works by rapidly altering brain chemistry to provide relief from symptoms such as sadness, hopelessness, and loss of interest in activities. Complete the Spravato® form below to see if this treatment may be right for you or a loved one. Columbia Mental Health is proud to offer Spravato®. Esketamine Spravato® is the first nasal spray approved by the Food and Drug Administration (FDA) to treat depression in adults who have not found relief with other antidepressants. This is known as treatment-resistant depression (TRD) and affects almost one-third of clients diagnosed with depression. Spravato® is used in conjunction with an oral antidepressant and is administered in our clinics under the close supervision of a healthcare professional. This innovative treatment option has been shown to be effective for many individuals who have not responded well to traditional antidepressant medications or talk therapy alone. Spravato® is not a cure for depression, but it can provide significant relief from symptoms and help individuals regain their quality of life. Spravato® may be covered under either your medical or pharmacy benefit, depending on your insurance plan. ## How does esketamine Spravato® work? Although the complete mechanism of action of esketamine Spravato® is unknown, clinical studies have shown that it helps treat depressive symptoms by targeting different neural receptors in the brain. It works through targeting of the N-methyl-D-aspartate (NMDA) receptor to improve brain plasticity via stimulation of brain-derived neurotropic factor (BDNF) production and activation of the mammalian target of rapamycin (mTOR). Esketamine Spravato® has been clinically proven to help patients in many ways: - Stabilizing mood - Decreasing the severity of depression - Delaying the return of symptoms - Taking effect in days rather than weeks - Reducing thoughts of suicide In one study of esketamine Spravato®, patients who stayed on esketamine Spravato® after 16 weeks of therapy had better results than patients who stopped therapy. Also, patients who received esketamine Spravato® showed a greater reduction of depressive symptoms than patients who received only a traditional oral antidepressant. ## ![](https://www.columbiapsychiatry-dc.com/wp-content/uploads/2024/12/63979de8-spravato-nasal-spray_10wa0wa0wa0se000022028-1-150x300.png) The Spravato® treatment program at Columbia Mental Health typically involves: - **Initial evaluation and screening** – An initial evaluation and screening process is required to determine whether Spravato® for depression is right for you - **An educational session on the use of Spravato®** – Our team of mental health professionals will provide an educational session to ensure you understand the use of Spravato® - **Administration of the medication** – The medication will be administered in our office by a qualified healthcare professional - **Regular monitoring** – Our mental health professionals will schedule regular visits to track your progress - **Ongoing therapeutic support** – This is an integral part of Spravato® treatment—our team will work with you to create an individualized plan that helps you develop strategies for managing your depression symptoms With our Spravato® services, we want the therapeutic experience to be supportive and motivating. We understand that depression can make it daunting for individuals to take control of their lives, so our team of mental health professionals is there with you every step of the way, even during initial screening sessions. With proper care, we firmly believe each client has the potential to achieve lasting mental well-being. ## The Spravato® treatment program at Columbia Associates typically involves: - **Initial evaluation and screening** – An initial evaluation and screening process is required to determine whether Spravato® for depression is right for you - **An educational session on the use of Spravato®** – Our team of mental health professionals will provide an educational session to ensure you understand the use of Spravato® - **Administration of the medication** – The medication will be administered in our office by a qualified healthcare professional - **Regular monitoring** – Our mental health professionals will schedule regular visits to track your progress - **Ongoing therapeutic support** – This is an integral part of Spravato® treatment—our team will work with you to create an individualized plan that helps you develop strategies for managing your depression symptoms With our Spravato® services, we want the therapeutic experience to be supportive and motivating. We understand that depression can make it daunting for individuals to take control of their lives, so our team of mental health professionals is there with you every step of the way, even during initial screening sessions. With proper care, we firmly believe each client has the potential to achieve lasting mental well-being. ![](https://www.columbiapsychiatry-dc.com/wp-content/uploads/2024/12/63979de8-spravato-nasal-spray_10wa0wa0wa0se000022028-1.png) ## How is Spravato® taken? The FDA approved esketamine Spravato® for use in conjunction with another oral antidepressant. Due to the commonly observed effects of esketamine Spravato®, it is only available through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) at a certified esketamine Spravato® center. On treatment days, patients should plan for transportation to and from Columbia Mental Health. Driving or operating machinery should not take place until after a full night of rest post-treatment. The initial therapy begins with two treatments per week for four weeks. After four weeks, you will be re-evaluated by a Columbia Mental Health provider and an individualized treatment plan will be tailored to your behavioral health needs, with treatments then tapered down for maintenance. Each time you receive esketamine Spravato®, the Columbia Mental Health nursing staff will observe you for a minimum of two hours at each treatment session. ## What are the most common side effects of Spravato®? Since esketamine is used in anesthesia, it has many of the same potential side effects as other anesthetics and pain medications. - Increased blood pressure - Anxiety - Dissociation - Dizziness - Nausea - Sedation - Impaired ability to drive or operate other machinery ## Testimonial Video Transcript _“There were days where I would just break down crying in my bathroom because I just couldn’t do it. I couldn’t. I couldn’t get up. I couldn’t take a shower. I couldn’t physically do anything._ _It was bad. I was, I was kind of cruel towards my mom at times, and there were points where she would just cry because of things I said or things I did. And I didn’t understand that I was being cruel. I didn’t understand that at all. I just lashed out._ _I ended up going to college. I stayed for about two months. Semester stared in August. I dropped down and was home before Halloween._ _I would sleep 18 to 20 hours a day. I wouldn’t shower for like 3 months. It was crazy. It was getting worse over time. I was having a lot more negative thoughts about myself. And so all these negative thoughts about how I just failed. I failed as a person. I failed myself. I failed my mom. I failed my teachers. It kind of spirals to the point where I really hated myself, and I remember thinking that I just want to fall asleep and never wake up again._ _I walked into my current psychiatrist with a legitimate page and a half full of medicines that I’ve already tried that didn’t work. We found out that I have treatment resistant depression._ _At some point, my psychiatrist talked to me about this medical trial study for Spravato. It really does help with treatment resistant depression.”_ **Spravato is the first FDA-approved nasal spray taken along with an oral antidepressant for adults with treatment resistant depression. It is not known if Spravato is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. Spravato is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of Spravato.** **Spravato is not for use as a medicine to prevent or relieve pain anesthetic, and it is not for use in children.** **Spravato can cause serious side effects, including sleepiness, fainting, dizziness, spinning sensation, anxiety, breathing problems, or feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation). Your healthcare provider will monitor you for at least two hours after taking Spravato. Please see additional Important Safety Information later in this video.** _“Sometimes with depression, not only do you like feel it emotionally, it feels like a weight. I was just so light. That was something so new to me. When I was truly in the my throes of depression, I would start every day off at like a -6, you know, versus a 0. After I started to take in Spravato and starting off the day, waking up neutral, which is like the best._ _My mom is my best friend. She is the best, and she has like sacrificed her entire life for me and she’s so good. And she is._ _I’m, actually, just finishing up my first semester. Eventually, I want to transfer out of my community college. I’m learning so much stuff, and I’m growing as a person, so it’s awesome._ _I’m 23 now, and I’m almost 24, and I never thought I would live to be 24. I just have so many opportunities. It’s awesome.”_ **IMPORTANT SAFETY INFORMATION** **What is Spravato (esketamine) CIII nasal spray?** Spravato is a prescribed medicine, used along with an antidepressant taken by mouth to treat: adults with treatment-resistant depression (TRD. Spravato is not for use as a medicine to prevent or relieve page (anesthetic). It is not known if Spravato is safe or effective as an anesthetic medicine. It is not known if Spravato is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. Spravato is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of Spravato. It is not known if Spravato is safe and effective in children. **What is the most important information I should know about Spravato?** Spravato can cause serious side effects, including: - **Sedation and dissociation.** Spravato may cause sleepiness (sedation), fainting, dizziness, spinning sensation, anxiety, or feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation). - Tell your healthcare provider right away if you feel like you cannot stay awake or if you feel like you are going to pass out. - Your healthcare provider must monitor you for serious side effects for at least 2 hours after taking Spravato. Your healthcare provider will decide when you are ready to leave the healthcare setting. - **Respiratory depression** **was observed** with the use of Spravato; additionally, there were rare reports of respiratory arrest. - Your healthcare provider must monitor you for serious side effects for at least 2 hours (including pulse oximetry) after taking Spravato. Your healthcare provider will decide when you are ready to leave the healthcare setting. - **Abuse and misuse.** There is a risk for abuse and physical and psychological dependence with Spravato treatment. Your healthcare provider should check you for signs of abuse and dependence before and during treatment with Spravato. - Tell your healthcare provider if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs. - Your healthcare provider can tell you more about the differences between physical and psychological dependence and drug addiction. - **Spravato Risk Evaluation and Mitigation Strategy (REMS).** Because of the risks for sedation, dissociation, respiratory depression, and abuse and misuse, Spravato is only available through a restricted program called the Spravato Risk Evaluation and Mitigation Strategy (REMS) Program. Spravato can only be administered at healthcare settings certified in the Spravato REMS Program. Patients treated in outpatient healthcare settings (e.g., medical offices and clinics) must be enrolled in the program. - **Increased risk of suicidal thoughts and actions.** Antidepressants medicines may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Spravato is not for use in children. - Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a higher risk of having suicidal thoughts or actions. These include people who have (or have a family history of) depression or a history of suicidal thoughts or actions. - **How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member?** - Pay close attention to any changes, especially sudden changes, in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions. - Tell your healthcare provider right away if you have any new or sudden changes in mood, behavior, thoughts, or feelings. - Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you have concerns about symptoms. - **Tell your healthcare provider right away if you or your family member have any of the following symptoms, especially if they are new, worse, or worrying you:** - Suicide attempts - Worsening depression - Thoughts about suicide or dying - Other unusual changes in behavior or mood **Do not take Spravato if you:** - Have blood vessel (aneurysmal vascular) disease (including in the brain, chest, abdominal aorta, arms and legs) - Have an abnormal connection between your veins and arteries (arteriovenous malformation - Have a history of bleeding in the brain - Are allergic to esketamine, ketamine, or any of the other ingredients in Spravato. If you are not sure if you have any of the above conditions, talk to your healthcare provider before taking Spravato. **Before you take Spravato, tell your healthcare provider about all of your medical conditions, including if you have:** - Have heart or brain problems, including: - High blood pressure (hypertension) - Slow or fast heartbeats that cause shortness of breath, chest pain, lightheadedness, or fainting - History of heart attack - History of stroke - Heart valve disease or heart failure - History of brain injury or any condition where there is increased pressure in the brain - Have liver problems - Have ever had a condition called “psychosis” (see, feel, or hear things that are not there, or believe in things that are not true) - Are pregnant or plan to become pregnant. Spravato may harm your baby. Your should not take Spravato if you are pregnant - Tell your healthcare provider right away if you become pregnant during treatment with Spravato. - If you are able to become pregnant, talk to your healthcare provider about methods to prevent pregnancy during treatment with Spravato. - There is a pregnancy registry for women who are exposed to Spravato during pregnancy. The purpose of the registry is to collect information about the health of women exposed to Spravato and their baby. If you become pregnant during treatment with Spravato, talk to your healthcare provider about registering with the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or online at [https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/](https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/). - Are breastfeeding or plan to breastfeed. You should not breastfeed during treatment with Spravato. **Tell your healthcare provider about all the medicines that your take,** including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking Spravato with certain medicine may cause side effects. **Especially tall your healthcare provider if you take** central nervous system (CNS) depressants, psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicine. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine. **How will I take Spravato?** - You will take Spravato nasal spray yourself, under the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the Spravato nasal spray device. - Your healthcare provider will tell you how much Spravato you will take and when you will take it. - Follow your Spravato treatment schedule exactly as your healthcare provider tells you to. - During and after each use of the Spravato nasal spray device, you will be checked by a healthcare provider who will decide when you are ready to leave the healthcare setting. - You will need to plan for a caregiver or family member to drive you home after taking Spravato. - If you miss a Spravato treatment, your healthcare provider may change your dose and treatment schedule. - Some people taking Spravato get nausea and vomiting. You should not eat at least 2 hours before taking Spravato and not drink liquids at least 30 minutes before taking Spravato. - If you take a nasal corticosteroid or nasal decongestant medicine, take these medicines at least 1 hour before taking Spravato. **What should I avoid while taking Spravato?** - **Do not** drive, operate machinery, or do anything where you need to be completely alert after taking Spravato. **Do not** take part in these activities until the next day following a restful sleep. See **“What is the most important information I should know about Spravato?”** **What are the possible side effects of Spravato?** Spravato may cause serious side effects including: See **“What is the most important information I should know about Spravato?”** - **Increased blood pressure.** Spravato can cause a temporary increase in your blood pressure that may last for about 4 hours after taking a dose. Your healthcare provider will check your blood pressure before taking Spravato and for at least 2 hours after you take Spravato. Tell your healthcare provider right away if you get chest pain, shortness of breath, sudden severe headache, change in vision, or seizures after taking Spravato. - **Problems with thinking clearly.** Tell your healthcare provider if you have problems thinking or remembering. - **Bladder problems.** Tell your health care provider if you develop trouble urinating, such as a frequent or urgent need to urinate, pain when urinating, or urinating frequently at night. - **The most common side effects of Spravato when used along with an antidepressant taken by mouth include:** - Feeling disconnected from yourself, your thoughts, feelings and things around you - Dizziness - Nausea - Feeling sleepy - Spinning sensation - Decreased feeling of sensitivity (numbness) - Feeling anxious - Lack of energy - Increased blood pressure - Vomiting - Feeling drunk - Feeling very happy or excited **If these common side effects occur, they usually happen right after taking Spravato and go away the same day.** These are not all the possible side effects of Spravato. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. **Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide for Spravato and discuss any questions you may have with your healthcare provider.** _“There were days where I would just break down crying in my bathroom because I just couldn’t do it. I couldn’t. I couldn’t get up. I couldn’t take a shower. I couldn’t physically do anything._ _It was bad. I was, I was kind of cruel towards my mom at times, and there were points where she would just cry because of things I said or things I did. And I didn’t understand that I was being cruel. I didn’t understand that at all. I just lashed out._ _I ended up going to college. I stayed for about two months. Semester stared in August. I dropped down and was home before Halloween._ _I would sleep 18 to 20 hours a day. I wouldn’t shower for like 3 months. It was crazy. It was getting worse over time. I was having a lot more negative thoughts about myself. And so all these negative thoughts about how I just failed. I failed as a person. I failed myself. I failed my mom. I failed my teachers. It kind of spirals to the point where I really hated myself, and I remember thinking that I just want to fall asleep and never wake up again._ _I walked into my current psychiatrist with a legitimate page and a half full of medicines that I’ve already tried that didn’t work. We found out that I have treatment resistant depression._ _At some point, my psychiatrist talked to me about this medical trial study for Spravato. It really does help with treatment resistant depression.”_ **Spravato is the first FDA-approved nasal spray taken along with an oral antidepressant for adults with treatment resistant depression. It is not known if Spravato is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. Spravato is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of Spravato.** **Spravato is not for use as a medicine to prevent or relieve pain anesthetic, and it is not for use in children.** **Spravato can cause serious side effects, including sleepiness, fainting, dizziness, spinning sensation, anxiety, breathing problems, or feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation). Your healthcare provider will monitor you for at least two hours after taking Spravato. Please see additional Important Safety Information later in this video.** _“Sometimes with depression, not only do you like feel it emotionally, it feels like a weight. I was just so light. That was something so new to me. When I was truly in the my throes of depression, I would start every day off at like a -6, you know, versus a 0. After I started to take in Spravato and starting off the day, waking up neutral, which is like the best._ _My mom is my best friend. She is the best, and she has like sacrificed her entire life for me and she’s so good. And she is._ _I’m, actually, just finishing up my first semester. Eventually, I want to transfer out of my community college. I’m learning so much stuff, and I’m growing as a person, so it’s awesome._ _I’m 23 now, and I’m almost 24, and I never thought I would live to be 24. I just have so many opportunities. It’s awesome.”_ **IMPORTANT SAFETY INFORMATION** **What is Spravato (esketamine) CIII nasal spray?** Spravato is a prescribed medicine, used along with an antidepressant taken by mouth to treat: adults with treatment-resistant depression (TRD. Spravato is not for use as a medicine to prevent or relieve page (anesthetic). It is not known if Spravato is safe or effective as an anesthetic medicine. It is not known if Spravato is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. Spravato is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of Spravato. It is not known if Spravato is safe and effective in children. **What is the most important information I should know about Spravato?** Spravato can cause serious side effects, including: - **Sedation and dissociation.** Spravato may cause sleepiness (sedation), fainting, dizziness, spinning sensation, anxiety, or feeling disconnected from yourself, your thoughts, feelings, space and time (dissociation). - Tell your healthcare provider right away if you feel like you cannot stay awake or if you feel like you are going to pass out. - Your healthcare provider must monitor you for serious side effects for at least 2 hours after taking Spravato. Your healthcare provider will decide when you are ready to leave the healthcare setting. - **Respiratory depression** **was observed** with the use of Spravato; additionally, there were rare reports of respiratory arrest. - Your healthcare provider must monitor you for serious side effects for at least 2 hours (including pulse oximetry) after taking Spravato. Your healthcare provider will decide when you are ready to leave the healthcare setting. - **Abuse and misuse.** There is a risk for abuse and physical and psychological dependence with Spravato treatment. Your healthcare provider should check you for signs of abuse and dependence before and during treatment with Spravato. - Tell your healthcare provider if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs. - Your healthcare provider can tell you more about the differences between physical and psychological dependence and drug addiction. - **Spravato Risk Evaluation and Mitigation Strategy (REMS).** Because of the risks for sedation, dissociation, respiratory depression, and abuse and misuse, Spravato is only available through a restricted program called the Spravato Risk Evaluation and Mitigation Strategy (REMS) Program. Spravato can only be administered at healthcare settings certified in the Spravato REMS Program. Patients treated in outpatient healthcare settings (e.g., medical offices and clinics) must be enrolled in the program. - **Increased risk of suicidal thoughts and actions.** Antidepressants medicines may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Spravato is not for use in children. - Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. Some people may have a higher risk of having suicidal thoughts or actions. These include people who have (or have a family history of) depression or a history of suicidal thoughts or actions. - **How can I watch for and try to prevent suicidal thoughts and actions in myself or a family member?** - Pay close attention to any changes, especially sudden changes, in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions. - Tell your healthcare provider right away if you have any new or sudden changes in mood, behavior, thoughts, or feelings. - Keep all follow-up visits with your healthcare provider as scheduled. Call your healthcare provider between visits as needed, especially if you have concerns about symptoms. - **Tell your healthcare provider right away if you or your family member have any of the following symptoms, especially if they are new, worse, or worrying you:** - Suicide attempts - Worsening depression - Thoughts about suicide or dying - Other unusual changes in behavior or mood **Do not take Spravato if you:** - Have blood vessel (aneurysmal vascular) disease (including in the brain, chest, abdominal aorta, arms and legs) - Have an abnormal connection between your veins and arteries (arteriovenous malformation - Have a history of bleeding in the brain - Are allergic to esketamine, ketamine, or any of the other ingredients in Spravato. If you are not sure if you have any of the above conditions, talk to your healthcare provider before taking Spravato. **Before you take Spravato, tell your healthcare provider about all of your medical conditions, including if you have:** - Have heart or brain problems, including: - High blood pressure (hypertension) - Slow or fast heartbeats that cause shortness of breath, chest pain, lightheadedness, or fainting - History of heart attack - History of stroke - Heart valve disease or heart failure - History of brain injury or any condition where there is increased pressure in the brain - Have liver problems - Have ever had a condition called “psychosis” (see, feel, or hear things that are not there, or believe in things that are not true) - Are pregnant or plan to become pregnant. Spravato may harm your baby. Your should not take Spravato if you are pregnant - Tell your healthcare provider right away if you become pregnant during treatment with Spravato. - If you are able to become pregnant, talk to your healthcare provider about methods to prevent pregnancy during treatment with Spravato. - There is a pregnancy registry for women who are exposed to Spravato during pregnancy. The purpose of the registry is to collect information about the health of women exposed to Spravato and their baby. If you become pregnant during treatment with Spravato, talk to your healthcare provider about registering with the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or online at [https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/](https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/). - Are breastfeeding or plan to breastfeed. You should not breastfeed during treatment with Spravato. **Tell your healthcare provider about all the medicines that your take,** including prescription and over-the-counter medicines, vitamins and herbal supplements. Taking Spravato with certain medicine may cause side effects. **Especially tall your healthcare provider if you take** central nervous system (CNS) depressants, psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicine. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine. **How will I take Spravato?** - You will take Spravato nasal spray yourself, under the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the Spravato nasal spray device. - Your healthcare provider will tell you how much Spravato you will take and when you will take it. - Follow your Spravato treatment schedule exactly as your healthcare provider tells you to. - During and after each use of the Spravato nasal spray device, you will be checked by a healthcare provider who will decide when you are ready to leave the healthcare setting. - You will need to plan for a caregiver or family member to drive you home after taking Spravato. - If you miss a Spravato treatment, your healthcare provider may change your dose and treatment schedule. - Some people taking Spravato get nausea and vomiting. You should not eat at least 2 hours before taking Spravato and not drink liquids at least 30 minutes before taking Spravato. - If you take a nasal corticosteroid or nasal decongestant medicine, take these medicines at least 1 hour before taking Spravato. **What should I avoid while taking Spravato?** - **Do not** drive, operate machinery, or do anything where you need to be completely alert after taking Spravato. **Do not** take part in these activities until the next day following a restful sleep. See **“What is the most important information I should know about Spravato?”** **What are the possible side effects of Spravato?** Spravato may cause serious side effects including: See **“What is the most important information I should know about Spravato?”** - **Increased blood pressure.** Spravato can cause a temporary increase in your blood pressure that may last for about 4 hours after taking a dose. Your healthcare provider will check your blood pressure before taking Spravato and for at least 2 hours after you take Spravato. Tell your healthcare provider right away if you get chest pain, shortness of breath, sudden severe headache, change in vision, or seizures after taking Spravato. - **Problems with thinking clearly.** Tell your healthcare provider if you have problems thinking or remembering. - **Bladder problems.** Tell your health care provider if you develop trouble urinating, such as a frequent or urgent need to urinate, pain when urinating, or urinating frequently at night. - **The most common side effects of Spravato when used along with an antidepressant taken by mouth include:** - Feeling disconnected from yourself, your thoughts, feelings and things around you - Dizziness - Nausea - Feeling sleepy - Spinning sensation - Decreased feeling of sensitivity (numbness) - Feeling anxious - Lack of energy - Increased blood pressure - Vomiting - Feeling drunk - Feeling very happy or excited **If these common side effects occur, they usually happen right after taking Spravato and go away the same day.** These are not all the possible side effects of Spravato. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. **Please see full Prescribing Information, including Boxed WARNINGS, and Medication Guide for Spravato and discuss any questions you may have with your healthcare provider.** ## Find out if Spravato® could help relieve your depression symptoms. [ Call Us \*DM\_DirectNumber format=period\* ](tel:703.682.8208) [ Complete the Spravato Form ](#form) ## Frequently Asked Questions What is Spravato®? Spravato® is a prescription medicine, used along with an antidepressant taken by mouth, for treatment-resistant depression (TRD) in adults. What is treatment-resistant depression? In Spravato® clinical trials, treatment-resistant depression was defined as a condition in which adults who are currently struggling with major depressive disorders have not responded adequately to at least two different antidepressants of adequate dose and duration. Is Spravato® safe? Spravato® is considered a safe treatment option with minimal side effects. Our team of mental health professionals will thoroughly evaluate your medical history and monitor for any potential adverse reactions throughout the treatment process. Does Spravato® hurt? Spravato® is a nasal spray, so it may cause some mild discomfort in the nasal passages during administration. Our team will provide tips and support to help make the experience more comfortable for you. Is Spravato® right for you? Spravato® may be an effective option for you if you’re struggling with treatment-resistant depression and haven’t achieved significant relief from other traditional treatments. Do you need a referral to be seen? You don’t need a referral to receive Spravato® treatment at Columbia Mental Health. Our team of mental health professionals is here to guide you through every step of the process—from your initial consultation to ongoing care and support. How soon will you see results? Many report noticeable symptom relief within a few days of starting Spravato® treatment. However, everyone’s experience is unique, and we’ll develop an individualized plan that fits your needs. In clinical studies, improvement of depression symptoms was demonstrated at four weeks of treatment with Spravato® plus an oral antidepressant, as compared with placebo nasal spray plus an oral antidepressant. What are the real-world outcomes of Spravato®? Spravato® has shown significant success in clinical trials. A study of people using Spravato® for over 30 days showed improved social functioning in 62% of participants. Additionally, 53% reported a better quality of life. There was a 41% increase in the ability to work, while 37% noted they could better meet their basic needs. Overall, 34% experienced improved general health.1 Does your insurance cover Spravato®? Yes, many health insurance plans cover Spravato®. Our team at Columbia Mental Health can check your coverage, explain your benefits, and help explore co-pay assistance or payment options. Where can I get Spravato®? Spravato® is only available at certified Spravato® treatment centers under the supervision of a properly trained healthcare professional. Due to the risks for sedation, dissociation, abuse, and misuse, your doctor will enroll you in the Spravato® Risk Evaluation and Mitigation Strategy (REMS) program. How effective is Spravato®? In a clinical study of adults with treatment-resistant depression, those who took Spravato® and an oral antidepressant experienced greater reduction in depression symptoms after four weeks, compared to those who received a placebo plus an oral antidepressant. How will I take Spravato®? You will take Spravato® nasal spray yourself with the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the Spravato® device, how much Spravato® to take and when to take it. Follow your treatment schedule exactly as your healthcare provider recommends. Your health provider will check on you during and after each use of the Spravato® nasal spray device and decide when you are ready to leave the healthcare setting. You will need to have a caregiver or family member drive you home after taking Spravato®. Do not eat for at least two hours before taking Spravato® and do not drink liquids for at least 30 minutes before taking Spravato®. If you take a nasal corticosteroid or nasal decongestant, use these medicines at least one hour before taking Spravato®. What are the most common side effects of Spravato®? Spravato® can cause serious side effects, including anxiety, dissociation, dizziness, nausea, sedation, spinning sensations, increased blood pressure, reduced sense of touch and sensation, lack of energy, vomiting, and feeling drunk. These common side effects usually occur right after taking Spravato® and then disappear the same day. Dissociation means feeling disconnected from yourself, your thoughts, feelings, space, and time. Spravato® may cause a temporary increase in blood pressure that can last about four hours after a dose. Your healthcare provider will check your blood pressure before you take Spravato® and for at least two hours after. Tell your provider immediately if you experience chest pain, shortness of breath, sudden severe headache, a change in vision, or seizures after taking Spravato®. Tell your provider if you have difficulty thinking or remembering, develop trouble urinating, have a frequent or urgent need to urinate, urinate frequently at night, or have pain when urinating. Who should not take Spravato®? Do NOT take Spravato® if any of the following apply to you: You are allergic to esketamine, a similar medicine called ketamine used for anesthesia, or any of the other ingredients in Spravato®. You have had medical conditions such as blood vessel disease (aneurysm), an abnormal connection between your blood vessels (arteriovenous malformation), or a history of bleeding in the brain. Be sure to tell your doctor if you have any heart (e.g., high blood pressure) or brain problems (e.g., stroke or history of brain injury), liver problems, psychosis, are pregnant or plan to become pregnant, or are breastfeeding or planning to breastfeed. You should not take Spravato® if you are pregnant. You should not breastfeed if you are taking Spravato®. Can I get treated with Spravato® for depression during pregnancy or breastfeeding? No, treatment with Spravato® is not recommended during pregnancy or while breastfeeding. You should let your doctor know if you are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed. If you are a woman planning to start Spravato® and are of childbearing age, you should use highly effective contraception while taking Spravato®. Talk with your doctor about methods of birth control that should be used. If you become pregnant while being treated with Spravato®, you should talk to your doctor as soon as possible about discontinuing treatment and about other options for treating your depression. What if I miss a Spravato® treatment? If you miss a Spravato® treatment, your healthcare provider may change your dose and treatment schedule. Be sure to let him or her know that you missed a treatment. What activities should I avoid while taking Spravato®? Do not drive, operate machinery, or perform any activity where you need to be completely alert. Avoid these activities until the next day following a restful sleep, even if you think you feel well enough to do so. Once your healthcare professional gives you permission to leave after treatment, discuss your plans for the remainder of that day. The driving restriction means you will need to plan for your rides on treatment days. Are there any food or beverage restrictions on my Spravato® treatment days? Some patients may experience nausea or vomiting. Because of this, you should avoid eating two hours before, and drinking liquids 30 minutes before, taking Spravato®. How is Spravato® nasal spray different from ketamine infusion? Spravato® (esketamine) CIII nasal spray is a derivative of ketamine. Spravato® is an FDA-approved nasal spray for treatment-resistant depression. Intravenous (IV) ketamine has not been approved by the FDA to treat depression. Both Spravato® and ketamine are Schedule III controlled substances under the U.S. Controlled Substances Act. How often will I take Spravato®? You’ll take Spravato® with a daily oral antidepressant twice a week for the first four weeks. After the first four weeks, you’ll take Spravato® once a week for a month. After this, you’ll typically take Spravato® either once a week or once every two weeks, according to your health provider. How long will I stay on Spravato®? You and your doctor will decide how long you stay on Spravato®, based on how you respond to it and how stable your response is. Your doctor will determine the dosing frequency based on how you feel. What should I do if I don’t respond to Spravato®? Not all patients respond to Spravato®. Your doctor may decide to have you complete the first four weeks of Spravato® treatment to see whether you have had satisfactory depression-symptom improvement. If so, talk to all of the healthcare professionals involved in the management of your treatment-resistant depression about appropriate next steps. Do not stop Spravato® treatments without first discussing your reasons/concerns with your doctor and formulating an alternate treatment plan. Spravato® is a prescription medicine, used along with an antidepressant taken by mouth, for treatment-resistant depression (TRD) in adults. In Spravato® clinical trials, treatment-resistant depression was defined as a condition in which adults who are currently struggling with major depressive disorders have not responded adequately to at least two different antidepressants of adequate dose and duration. Spravato® is considered a safe treatment option with minimal side effects. Our team of mental health professionals will thoroughly evaluate your medical history and monitor for any potential adverse reactions throughout the treatment process. Spravato® is a nasal spray, so it may cause some mild discomfort in the nasal passages during administration. Our team will provide tips and support to help make the experience more comfortable for you. Spravato® may be an effective option for you if you’re struggling with treatment-resistant depression and haven’t achieved significant relief from other traditional treatments. You don’t need a referral to receive Spravato® treatment at Columbia Mental Health. Our team of mental health professionals is here to guide you through every step of the process—from your initial consultation to ongoing care and support. Many report noticeable symptom relief within a few days of starting Spravato® treatment. However, everyone’s experience is unique, and we’ll develop an individualized plan that fits your needs. In clinical studies, improvement of depression symptoms was demonstrated at four weeks of treatment with Spravato® plus an oral antidepressant, as compared with placebo nasal spray plus an oral antidepressant. Spravato® has shown significant success in clinical trials. A study of people using Spravato® for over 30 days showed improved social functioning in 62% of participants. Additionally, 53% reported a better quality of life. There was a 41% increase in the ability to work, while 37% noted they could better meet their basic needs. Overall, 34% experienced improved general health.1 Yes, many health insurance plans cover Spravato®. Our team at Columbia Mental Health can check your coverage, explain your benefits, and help explore co-pay assistance or payment options. Spravato® is only available at certified Spravato® treatment centers under the supervision of a properly trained healthcare professional. Due to the risks for sedation, dissociation, abuse, and misuse, your doctor will enroll you in the Spravato® Risk Evaluation and Mitigation Strategy (REMS) program. In a clinical study of adults with treatment-resistant depression, those who took Spravato® and an oral antidepressant experienced greater reduction in depression symptoms after four weeks, compared to those who received a placebo plus an oral antidepressant. You will take Spravato® nasal spray yourself with the supervision of a healthcare provider in a healthcare setting. Your healthcare provider will show you how to use the Spravato® device, how much Spravato® to take and when to take it. Follow your treatment schedule exactly as your healthcare provider recommends. Your health provider will check on you during and after each use of the Spravato® nasal spray device and decide when you are ready to leave the healthcare setting. You will need to have a caregiver or family member drive you home after taking Spravato®. Do not eat for at least two hours before taking Spravato® and do not drink liquids for at least 30 minutes before taking Spravato®. If you take a nasal corticosteroid or nasal decongestant, use these medicines at least one hour before taking Spravato®. Spravato® can cause serious side effects, including anxiety, dissociation, dizziness, nausea, sedation, spinning sensations, increased blood pressure, reduced sense of touch and sensation, lack of energy, vomiting, and feeling drunk. These common side effects usually occur right after taking Spravato® and then disappear the same day. Dissociation means feeling disconnected from yourself, your thoughts, feelings, space, and time. Spravato® may cause a temporary increase in blood pressure that can last about four hours after a dose. Your healthcare provider will check your blood pressure before you take Spravato® and for at least two hours after. Tell your provider immediately if you experience chest pain, shortness of breath, sudden severe headache, a change in vision, or seizures after taking Spravato®. Tell your provider if you have difficulty thinking or remembering, develop trouble urinating, have a frequent or urgent need to urinate, urinate frequently at night, or have pain when urinating. Do NOT take Spravato® if any of the following apply to you: You are allergic to esketamine, a similar medicine called ketamine used for anesthesia, or any of the other ingredients in Spravato®. You have had medical conditions such as blood vessel disease (aneurysm), an abnormal connection between your blood vessels (arteriovenous malformation), or a history of bleeding in the brain. Be sure to tell your doctor if you have any heart (e.g., high blood pressure) or brain problems (e.g., stroke or history of brain injury), liver problems, psychosis, are pregnant or plan to become pregnant, or are breastfeeding or planning to breastfeed. You should not take Spravato® if you are pregnant. You should not breastfeed if you are taking Spravato®. No, treatment with Spravato® is not recommended during pregnancy or while breastfeeding. You should let your doctor know if you are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed. If you are a woman planning to start Spravato® and are of childbearing age, you should use highly effective contraception while taking Spravato®. Talk with your doctor about methods of birth control that should be used. If you become pregnant while being treated with Spravato®, you should talk to your doctor as soon as possible about discontinuing treatment and about other options for treating your depression. If you miss a Spravato® treatment, your healthcare provider may change your dose and treatment schedule. Be sure to let him or her know that you missed a treatment. Do not drive, operate machinery, or perform any activity where you need to be completely alert. Avoid these activities until the next day following a restful sleep, even if you think you feel well enough to do so. Once your healthcare professional gives you permission to leave after treatment, discuss your plans for the remainder of that day. The driving restriction means you will need to plan for your rides on treatment days. Some patients may experience nausea or vomiting. Because of this, you should avoid eating two hours before, and drinking liquids 30 minutes before, taking Spravato®. Spravato® (esketamine) CIII nasal spray is a derivative of ketamine. Spravato® is an FDA-approved nasal spray for treatment-resistant depression. Intravenous (IV) ketamine has not been approved by the FDA to treat depression. Both Spravato® and ketamine are Schedule III controlled substances under the U.S. Controlled Substances Act. You’ll take Spravato® with a daily oral antidepressant twice a week for the first four weeks. After the first four weeks, you’ll take Spravato® once a week for a month. After this, you’ll typically take Spravato® either once a week or once every two weeks, according to your health provider. You and your doctor will decide how long you stay on Spravato®, based on how you respond to it and how stable your response is. Your doctor will determine the dosing frequency based on how you feel. Not all patients respond to Spravato®. Your doctor may decide to have you complete the first four weeks of Spravato® treatment to see whether you have had satisfactory depression-symptom improvement. If so, talk to all of the healthcare professionals involved in the management of your treatment-resistant depression about appropriate next steps. Do not stop Spravato® treatments without first discussing your reasons/concerns with your doctor and formulating an alternate treatment plan. ![](https://www.columbiapsychiatry-dc.com/wp-content/uploads/2023/01/Path-1003.png) “I became interested again in the things I had set aside for over a year, such as crafting, crocheting, writing — I even started to become more present with my family and at my job.” Carol “I was hoping to at least shake the dark cloud a little bit and have a couple of days without feeling so down. But to my surprise, those days are gone. Absolutely gone.” Krista ![](https://www.columbiapsychiatry-dc.com/wp-content/uploads/2023/01/Path-1004.png) ## What is Spravato®? [https://www.columbiapsychiatry-dc.com/wp-content/uploads/2023/03/Sparvato-1-1.mp4](https://www.columbiapsychiatry-dc.com/wp-content/uploads/2023/03/Sparvato-1-1.mp4) ## How to Use Spravato®? [https://www.columbiapsychiatry-dc.com/wp-content/uploads/2023/03/Sparvato-2.mp4](https://www.columbiapsychiatry-dc.com/wp-content/uploads/2023/03/Sparvato-2.mp4) ## Find out if Spravato® could help relieve your depression symptoms. [ Call Us \*DM\_DirectNumber format=period\* ](tel:703.682.8208) [ Complete the Spravato Form ](#form) ## Connect with Columbia Mental Health to Get Spravato® Treatment in the Washington DC Metro Area Have traditional depression treatments failed you? Columbia Mental Health is proud to provide Spravato® as part of a full suite of mental health services, including therapy, psychiatric medication management, and alternative options for treatment-resistant depression. This collaborative, multidisciplinary approach allows our team to create an individualized treatment plan that is tailored to you. Call \[Direct\] for more information. You can also complete the Spravato® form to determine if you or a loved one are a good candidate to receive this type of treatment for depression. [View Full Prescribing Information. ](https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/SPRAVATO-pi.pdf) [ Complete the Spravato Form ](#form) Footnote: [Janssen Scientific Affairs – Real World Evidence – Effectiveness and Safety of SPRAVATO Therapy](https://www.janssenscience.com/products/spravato/medical-content/real-world-evidence-effectiveness-and-safety-of-spravato-therapy)