Spravato (Esketamine) Treatment

Available NOW at Hope TMS Center

What is Spravato?

Spravato (Esketamine) is FDA approved medication for Treatment-Resistant Depression. Spravato is a special form of Ketamine that is administered as a nasal spray.


Spravato  is indicated for patients that  have a history of Major Depressive Disorder that did not respond or tolerate two antidepressants in the current episode .

Spravato is recommended in conjunction with a conventional antidepressant.

For more detailed information consult spravato.com or Contact us

Who is a candidate for Esketamine (Spravato)?

Spravato is FDA approved only for treatment resistant Major Depressive Disorder. It is not currently approved for the treatment of a depressive episodes of bipolar disorder.

A thorough   evaluation will be performed to consider if you are appropriate candidate. Only patients that are approved by a restrictive program called Spravato REMS are eligible to receive this medication for Major Depressive Disorder.

Administration of Spravato is a part of comprehensive treatment strategy.

In order to achieve the maximum of benefit from this medication regimen, the patient is required :

  • to continue regular psychiatric care with the referring psychiatrist and medication follow up as prescribed

  • to continue psychotherapy

  • to work on improving his/her life style such eating habits, sleep hygiene, consistent physical activity

  • to continue  care with the GP  for any other medical conditions

  • Alcohol and recreational drugs are prohibited.

Before each treatment with Spravato

  • update treatment team of any change in medication, and medical condition
  • Do not eat and drink 2 hrs before the treatment
  • Make sure that your cell is turned off before starting the treatment.
  • Make appropriate arrangement for safe transportation. You can not drive and you can not make major decision the day of the treatment after administration of Spravato

What to expect?

Before the first administration of Spravato you will be evaluated by Dr Ghelber. You will need to register with the Spravato REMS program and your insurance needs to preapprove the medication.

The day of the treatment

You will be greeted by the office staff, and your blood pressure will be measured. If your blood pressure is high, there is a possibility for cancelation. Please make sure that you take your prescribed blood pressure medications  before arrival to the office to prevent possible delays or cancelations. If you are on a nasal decongestant, please use it at least one hour prior to the treatment.

Please refrain from eating for two hours before the treatment and refrain from liquids for half an hour before. However, eating or drinking prior to the administration of Spravato are not contraindications for the treatment, but you may suffer from more nausea.

The administration

Esketamine is administered as one or more doses of a nasal spray, in a comfortable dark room. You are encouraged to rest and keep quiet while Spravato takes effect.

Side effects

Esketamine is administered as one or more doses of a nasal spray, in a comfortable dark room. You are encouraged to rest and keep quiet while Spravato takes effect.

The most common side effects of Spravato are perception changes including illusions, distortions of space, time and colors. Such side effects are collectively known as a dissociative state. For short periods of time, the cognitive (intellectual) performance is decreased. You might be sedated (tired) during and after the treatment. Spravato may produce urgency (sensation of badly wanting to urinate) and other urinary symptoms.

Ketamine and Esketamine have the potential of abuse and addiction.

Please inform us if you are pregnant to discuss possible safer alternatives.

After the treatment 

You cannot drive home by yourself and you should not drive, operate machinery or take important decisions until the day after the Spravato treatment.

Treatment with Esketamine necessitates multiple appointments and dedication. Please consider these prior to enrolling in the Esketamine program.



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