If you’re considering Spravato (esketamine) for treatment-resistant depression, you likely have questions about how it works, how quickly it takes effect, and what to expect. To help, we’ve compiled answers to the most common questions patients ask about Spravato treatment in NYC.
1. What is Spravato and how does it work for depression?
Spravato (esketamine) is an FDA-approved treatment for adults with treatment-resistant depression, meaning depression that hasn’t improved after trying other medications. Unlike traditional antidepressants such as SSRIs or SNRIs, which act on serotonin or norepinephrine, Spravato works on the NMDA receptor, a part of the brain’s glutamate system.
By targeting glutamate, the most common excitatory neurotransmitter in the brain, Spravato helps increase synaptic plasticity, or the brain’s ability to form new connections. This unique mechanism of action is thought to be one reason why some patients experience improvement within hours to days, instead of waiting weeks like with standard medications.
2. Who qualifies for Spravato treatment?
Spravato is approved for adults with:
- Treatment-resistant depression (failed at least two antidepressants)
- Major depressive disorder with suicidal thoughts or behaviors
Eligibility is determined after a comprehensive psychiatric evaluation.
3. How quickly does Spravato work?
Many patients notice improvement within the first few weeks of treatment.
Unlike traditional antidepressants, which can take four to six weeks to show results, Spravato often begins working sooner. Some patients feel changes after their first few sessions, while for others, improvement builds gradually over two to four weeks.
4. How is Spravato different from regular antidepressants?
Spravato works on the NMDA receptor in the brain, affecting the glutamate system rather than serotonin.
This gives Spravato a unique mechanism of action compared to SSRIs or SNRIs. By targeting glutamate pathways through the NMDA receptor, Spravato may lead to faster improvement in depressive symptoms in patients who have not responded to standard medications.
5. Is Spravato safe?
Yes, when administered in a certified clinic with proper monitoring.
Because Spravato may cause temporary side effects such as dizziness or dissociation, patients are required to:
- Receive treatment in a REMS-certified clinic like Being Health
- Be monitored by trained clinicians for at least two hours after each dose
- Avoid driving until the next day
At Being Health, we follow gold-standard safety protocols to ensure every patient’s wellbeing throughout the process.
6. Does insurance cover Spravato?
Yes. Most major NYC insurers cover Spravato with prior authorization.
Covered plans typically include:
- Aetna
- Cigna
- UnitedHealthcare
- Oscar
- Northwell Direct
Our care team handles the insurance process on your behalf, including prior authorization and documentation of treatment-resistant depression, so you can focus on recovery instead of paperwork.
7. What is a Spravato session like?
Each treatment session lasts about 2–2.5 hours and includes:
- Check-in and vitals
- Self-administered nasal spray dosing under clinical supervision
- Relaxation and monitoring for two hours
- Safe discharge with a designated driver
The setting at Being Health is private, calm, and designed to support healing.
8. What are common side effects of Spravato?
Like all medications, Spravato can cause side effects. The most commonly reported include:
- Feeling dizzy or lightheaded
- Dissociation (feeling disconnected from your body or surroundings)
- Drowsiness or sedation
- Nausea
- Temporary increases in blood pressure
Because of these possible effects, Spravato is only given in REMS-certified clinics under medical supervision. At Being Health, patients are monitored closely for at least two hours after each session to ensure safety before heading home. Most side effects are short-lived and resolve the same day.
9. How is Spravato different from ketamine infusions?
Both Spravato and ketamine treatments use forms of ketamine to treat depression, but there are key differences:
- Spravato (esketamine): A nasal spray made from one component of ketamine. It is FDA-approved specifically for treatment-resistant depression or major depressive disorder with suicidal ideation, and must be administered in a REMS-certified clinic.
- Ketamine treatments: These involve intravenous (IV) infusions or intramuscular (IM) injections of ketamine (the full compound, not just esketamine). While not FDA-approved for depression, ketamine therapy is supported by a growing body of clinical research and is widely used off-label in specialized clinics. Unlike Spravato, Ketamine treatments are not covered by insurance.
At Being Health, we provide both Spravato and ketamine treatments, allowing patients and clinicians to choose the treatment approach that best fits individual needs.
10. What other treatment options are available if Spravato doesn’t work?
At Being Health, we offer both Spravato and ketamine treatments, giving patients two evidence-based options that work through the glutamate system. If one isn’t effective, patients may respond to the other. For individuals who need a different approach, other treatments such as TMS or ECT may be considered in collaboration with outside providers. Our team will guide you through the best options for your unique needs.
11. Where can I get Spravato treatment in New York City?
Spravato (esketamine) can only be given in REMS-certified clinics under the supervision of trained medical professionals. If you’re in New York City, Being Health is proud to be one of the clinics offering Spravato in a safe, supportive, and modern setting.
Our office is conveniently located in the Financial District of Manhattan, making it accessible to patients across NYC. At Being Health, every Spravato session is conducted in a comfortable environment with medical monitoring for at least two hours, as required by the FDA REMS program.
Choosing Being Health means you’ll receive not only Spravato treatment, but also the option of IV/IM ketamine therapy and access to a team that takes a comprehensive, integrative approach to mental health care. We work with you to create a personalized treatment plan and coordinate with your existing providers.
Next Steps
Spravato offers a new path forward for patients who haven’t found relief with traditional antidepressants. While every patient’s experience is unique, the research and real-world outcomes are promising.
For more personalized answers and to learn if Spravato is right for you, schedule a consultation with Being Health today or give us a call at 888-668-7600.
