SPRAVATO® (ESKETAMINE)
For Treatment-Resistant Depression
FDA-Approved In-Office Treatment for Depression That Hasn't Responded to Antidepressants
Spravato® is an FDA-approved nasal spray, administered in our clinic, that works on different brain pathways than traditional antidepressants. Designed for adults with treatment-resistant depression who haven't found adequate relief from oral medications.
- FDA-approved for treatment-resistant depression and MDD with suicidal ideation
- Clinician-supervised in-office treatment — no daily medication to manage
- Works differently than antidepressants — targets glutamate, not serotonin
- Many patients notice improvement within the first few sessions
- Most major insurance plans accepted
As Seen On AZ Family
Find Out If Spravato Is Right for You
Schedule a free 15-minute consultation. Our clinical team will review your history and check your eligibility — no commitment required.
Schedule Free Consultation →- ✓ Most major insurance accepted
- ✓ Free eligibility screening — no cost to you
- ✓ Same-week appointments available
- ✓ Gilbert, AZ clinic — in-office treatment
Prefer to call? 480-536-9473
Schedule a Consultation
Book a free 15-minute call online. No commitment required — this is the first step to finding out if you qualify.
Clinical Screening Call
A member of our clinical team calls to review your depression history, prior medication trials, and basic eligibility.
In-Clinic Evaluation
You meet with one of our providers for a full psychiatric evaluation and to confirm you meet Spravato criteria.
Treatment Scheduled
If appropriate, we handle insurance verification and schedule your first session.
✓ You may be a good candidate if you:
- Have been diagnosed with major depressive disorder (MDD)
- Have tried 2 or more antidepressants without adequate relief
- Are currently experiencing significant depressive symptoms
- Are able to attend in-office sessions (cannot drive after treatment)
- Are not pregnant or breastfeeding
✕ Spravato may not be appropriate if you:
- Have a history of psychosis or schizophrenia
- Have active or unstable cardiovascular disease
- Have uncontrolled hypertension
- Have a history of substance use disorder (evaluated case-by-case)
- Have not yet tried antidepressant medications
How It Works
Spravato contains esketamine, a molecule that acts on NMDA receptors in the brain — a completely different pathway than traditional antidepressants, which target serotonin or norepinephrine. This distinct mechanism is why Spravato can be effective for patients who have not responded to standard medications.
What It Treats
Spravato is FDA-approved for two specific conditions:
- Treatment-Resistant Depression (TRD) — for adults with MDD who have not responded to at least two antidepressant treatments
- Major Depressive Disorder with Acute Suicidal Ideation (MDSI) — for adults needing rapid symptom reduction
What to Expect During a Session
- Arrive at clinic — settled into a private treatment room
- Provider administers the nasal spray (56mg or 84mg)
- Mandatory 2-hour monitoring period after each dose
- Temporary effects (dissociation, dizziness) resolve before you leave
- You cannot drive home — arrange transportation in advance
Induction
Two sessions per week for the first four weeks. This phase delivers the core therapeutic benefit. Many patients begin to notice improvement within the first two weeks.
Maintenance (Initial)
Sessions taper to once per week for four weeks. This phase consolidates the gains from induction and continues building toward sustained relief.
Ongoing Maintenance
Your provider evaluates your response and determines the appropriate long-term frequency — typically once weekly or once every two weeks.
Combination Therapy (Most Common): Spravato is typically prescribed alongside a standard oral antidepressant. Your provider will review your current medications and may adjust or initiate one as part of your treatment plan.
Monotherapy Option (FDA-Approved): As of 2024, the FDA approved Spravato as a standalone monotherapy — meaning it can be used without a concurrent antidepressant. This is specifically relevant for patients who have failed multiple antidepressants, are no longer willing to try them, or for whom restarting an antidepressant is clinically contraindicated. If this describes you, let our team know during your intake call — you may still qualify.
Maximize Your Results: Clinical outcomes with Spravato — and ketamine-based treatments generally — are significantly enhanced when treatment is paired with ketamine coaching or integrative therapy led by a trained professional. The neuroplasticity window opened by each session creates an optimal opportunity for deeper psychological work. Ask our team about integrative therapy options at Unchained.
REMS Certified Facility
Spravato can only be administered in a REMS-certified healthcare setting. Unchained Psychiatry & Wellness is a certified Spravato treatment center. Every dose is administered and supervised on-site.
Medical Clearance
We review your cardiovascular history, blood pressure, current medications, and any conditions that may affect treatment safety before any session begins.
Psychiatric Assessment
Our providers assess your current psychiatric status, including co-occurring diagnoses, substance use history, and history of psychosis. Spravato is not appropriate for everyone.
Mandatory Monitoring
Every patient is monitored in our clinic for a minimum of two hours after each dose. You are assessed for dissociation, sedation, and blood pressure changes before you are cleared to leave.
Insurance Coverage
Spravato is covered by most major insurance plans when clinical criteria are met. Our team handles benefits verification and prior authorization before your first session — no surprises.
What Insurance Requires
- Diagnosis of Treatment-Resistant Depression
- Documentation of 2+ failed antidepressant trials
- Evaluation by a board-certified psychiatric provider
- Enrollment in the Spravato REMS program
Spravato withMe™ Savings Program
Janssen offers a savings card for eligible commercially insured patients that can dramatically reduce your out-of-pocket costs:
Covers your medication copay, deductible & coinsurance
Reimburses your observation & monitoring copay
Our team will help you enroll before your first session.
Not valid for Medicare, Medicaid, or other government-funded programs.
REMS Certified Provider
Certified under the Spravato REMS program. Every session administered and monitored by trained clinical staff in a dedicated treatment room.
Board-Certified Oversight
Your treatment plan is developed and supervised by a board-certified psychiatric provider. Spravato is never administered without a thorough clinical evaluation.
Insurance Navigation
We handle benefits verification, prior authorization, and all communication with your insurance provider — before treatment begins.
Comfortable Environment
Private treatment rooms, attentive staff, and a supportive environment throughout your 2-hour monitoring window after every session.
Integrated Care
With your consent, we coordinate with your existing psychiatrist, therapist, or primary care provider to ensure a unified approach.
Full-Spectrum Options
If Spravato isn't the right fit, we also offer IV ketamine infusions, TMS therapy, medication management, and ketamine coaching — all under one roof.
FIND OUT IF SPRAVATO IS RIGHT FOR YOU
Spravato is covered by most major insurance plans when clinical criteria are met. Schedule a free consultation and our team will verify your coverage before your first visit.
Schedule Free Consultation →Insurance verification and clinical evaluation required before treatment begins. Spravato® is a registered trademark of Janssen Pharmaceuticals, Inc. Coverage and eligibility vary by plan.
Unchained Psychiatry & Wellness · 201 W Guadalupe Rd, Suite 302, Gilbert, AZ 85233 · 480-536-9473