Spravato (esketamine) is an FDA-approved nasal spray derived from ketamine that targets NMDA receptors in the brain — a completely different mechanism than traditional antidepressants, which work on serotonin and norepinephrine. This difference is significant: if you’ve tried multiple antidepressants without success, it’s likely because those medications were all working on the same pathway. Spravato bypasses that pathway entirely, which is why it can work for people who haven’t responded to anything else.

Yes, many major insurance plans cover Spravato for patients who meet the clinical criteria for treatment-resistant depression, including Aetna, Blue Cross Blue Shield, Cigna, United Health Group/Optum, and others. Medicare and Medicaid coverage is also available in many cases. Because Spravato requires prior authorization, our team assists you through that process before your first session to maximize your benefits and minimize out-of-pocket costs.

Many patients report meaningful improvement in their depressive symptoms within 1–2 sessions — sometimes within hours of their first treatment. This rapid onset is one of the most significant differences between Spravato and traditional antidepressants, which typically take 4–6 weeks to produce any noticeable effect. Results vary from person to person, but the speed of response is consistently one of the most remarkable aspects of this treatment.

You’ll self-administer the nasal spray under Carolyne’s direct supervision. Within minutes, you may experience temporary dissociative effects — a sense of detachment, altered perception, or mild dizziness. These effects are expected, well-documented, and typically resolve within 1–2 hours. You’ll be monitored throughout and will rest comfortably in the office during this time. Most patients describe the experience as manageable, and Carolyne will prepare you thoroughly before your first session so nothing comes as a surprise.

No. Spravato is designed to be used alongside an oral antidepressant, not as a replacement for one. It is not a standalone treatment — it works best as part of a comprehensive psychiatric care plan. Carolyne will review your current medications during your evaluation and ensure that your full treatment plan is safe, coordinated, and optimized for the best possible outcome.

Treatment is divided into two phases. The induction phase runs for the first 4 weeks, with twice-weekly sessions to establish the therapeutic effect. The maintenance phase follows, with sessions reducing to once weekly for weeks 5–8, then every 1–2 weeks ongoing depending on your response. Many patients continue maintenance sessions long-term to sustain their results — Carolyne will monitor your progress closely and adjust the schedule as needed.

Spravato has been through rigorous FDA clinical trials and is considered safe when administered in a certified healthcare setting under proper medical supervision. The most common side effects are temporary and occur during the session itself — dissociation, dizziness, nausea, and increased blood pressure. This is why you are monitored for at least 2 hours after every session and cannot drive that day. Spravato is not appropriate for everyone — patients with certain medical or psychiatric conditions may not be eligible, which is why a thorough evaluation is required before starting.

At Mind Garden, Spravato is never administered in isolation. Every patient receives personalized psychiatric oversight from Carolyne throughout their entire treatment — not just a nurse monitoring vitals while you sit in a chair. Your Spravato protocol is fully integrated into your broader care plan, which means your medication, lifestyle factors, and treatment schedule are all being actively managed and optimized together. You’re not a number moving through a protocol. You’re a patient whose full picture is always in view.