Spravato (Esketamine) 


Embark on a transformative journey towards lasting relief from severe depression through our comprehensive Spravato (Esketamine) Treatment at Shore Clinical TMS Therapy and Wellness Center. 

SPRAVATO© is an FDA-approved nasal spray prescription medication for adults with treatment-resistant depression to be used along with an oral antidepressant for:

  • Adults with major depressive disorder (MDD)
  • Patients who have had an insufficient response to 2 or more oral ADs
  • Adults with MDD, along with acute suicidal ideation or behavior

As a groundbreaking breakthrough in psychiatric care, Spravato employs a novel approach that targets key molecules, receptors, and mechanisms in the brain, setting it apart from conventional treatment methods.

Benefits of Spravato (Esketamine) Treatment


  • Swift Relief: Experience rapid alleviation of treatment-resistant depression, often noticeable within 24 to 48 hours after treatment initiation.
  • Extended Positive Effects: Unlike conventional medications, where positive effects are only present while the drug is in the body, Spravato indudes long-term improvements in mood that persist even after the drug has been metabolized and eliminated.
  • Focused Neurotransmitter System: While traditional antidepressants predominantly influence serotonin or norepinephrine systems, Spravato directly targets the glutamate neurotransmitter system. This unique approach triggers a substantial increase in glutamate release, leading to heightened neuroplasticity.
  • Enhanced Neuroplasticity: By stimulating key receptors in the brain, Spravato promotes the release of "brain growth molecules" like BDNF (brain-derived neurotrophic factor). This process enhances neuroplasticity, empowering the brain to restructure itself and form stronger connections, resulting in improved mood, thought patterns, and overall cognition.
  • Hope for Treatment-Resistant Depression: SPRAVATO© has been proven to be effective in adults with treatment-resistant depression. A short-term clinical study found that SPRAVATO© taken concurrently with oral antidepressants showed decreased depressive symptoms within 4 weeks compared to those who had taken placebo. After 16 weeks, patients who continued maintenance were less likely to experience relapse than those who stopped treatment.


If you find yourself within the challenging realm of severe depression resistant to traditional antidepressants, Spravato (Esketamine) emerges as a novel and promising option. Our experienced team is dedicated to providing personalized care, guiding you through a tailored treatment plan that incorporates the transformative potential of Spravato. Your path to renewed well-being begins with the innovative and scientifically-backed Spravato treatment at Shore Clinical TMS & Wellness Center, where we are committed to fostering lasting relief and empowering you on your journey to mental health.

How Spravato Treatment Works


SPRAVATO nasal spray is self-administered under a healthcare provider's supervision in a certified treatment center that's registered in the SPRAVATO© Risk Evaluation and Mitigation Strategy (REMS) Program.


Before Treatment

  • Don't eat 2 hours before administration.
  • Don't drink any liquids 30 minutes before administration.
  • Don't use any other nasal corticosteroid or nasal decongestants 1.5 hours before administration before administration.
  • Feel free to bring a companion to sit with you during treatment for the first session.
  • Prepare a ride to pick you up from treatment, as you will not be permitted either to drive or to operate heavy machinery for up to 24 hours following treatment.
  • A technician will take your initial BP before starting. Provider approval is required to begin treatment that day, depending on your BP.


During Treatment

The treatment center will provide a relaxing, meditative environment to instill mindfulness, mental wellness, and positivity throughout the treatment.

  • Once a provider has approved you to begin treatment, you'll receive 2 nasal spray devices (28 mg each) of SPRAVATO© for a total of 56 mg, on your first visit.
  • Each session after, you may receive a 3rd device for a total of 84 mg contingent upon your BP.
  • Technicians will also take your BP about 40 minutes after the last device is administered and 2 hours after the first device is administered.
  • We recommend patients fall into a meditative state during treatment. It can be beneficial to think about one’s goals they would like to accomplish, their affirmations, or a motto/slogan they would like to live by.

Treatment Frequency:

  • 1st month: 1-2x weekly
  • 2nd month: 1x weekly
  • 3rd month: biweekly


After Treatment

The patient will meet with the provider after the 3rd, 8th, and 14th treatment. The provider will decide if maintenance (biweekly treatment) is medically necessary, going forward.

Safety Information


  • Don't take Spravato if you have a blood vessel disease, an abnormal connection between veins and arteries, a history of brain bleeding, or are allergic to esketamine.
  • Before starting Spravato treatment, please consult with your healthcare provider if you have heart or brain problems, are pregnant or breastfeeding, have a history of alcohol or drug abuse, or have psychosis.
  • Your care provider will check your blood pressure and heart rate intermittently to ensure safety throughout the treatment due to high blood pressure being a side effect of the medication. 
  • Since the treatment can cause dissociation and sedation, you must have a ride to and from the office.

Spravato With Me Savings Program

If you’re eligible and commercially insured, the Spravato With Me Savings Program may help you pay as little as $10 per treatment. Of course, there are quantity limits and savings limits each year. These savings may apply to your co-pay, co-insurance, or deductible. The program doesn't cover the cost of treatment observation, only the medication itself. 

You can participate without sharing your income information. Check program requirements at


Frequently Asked Questions (FAQ) on Spravato

If you've taken two or more antidepressants with the prescribed dose and duration, and still struggle with depressive symptoms, talk with your healthcare provider to see if SPRAVATO© is right for you. Patients must also score adequately on a standardized depression scale and should currently be taking an antidepressant.

The most commonly-used oral antidepressants target neurotransmitters such as serotonin, dopamine, or norepinephrine. SPRAVATO targets the N-methyl-D-aspartate (NMDA) receptor and is believed to work differently from typical oral antidepressants. But the exact method is unknown.

A full course of Spravato nasal spray treatment ordinarily requires 6-8 weeks of treatment (once or twice a week), with less frequent maintenance treatment in the following months. For the first 4 weeks you come in twice per week, each time for a two-and-a-half-hour visit.

In the second month your visits are once per week. After that, treatments for long-term maintenance with Spravato (esketamine) might be once per week or twice per month, depending on your clinical course.

Common side effects include transient sedation, a possible rise in your blood pressure, abuse and misuse, increased suicidal ideation or behavior, increased blood pressure, problems with thinking clearly, bladder problems, and feelings of dissociation (such as feeling strange, disconnected, or change in sense of time). 

Other side effects include:

  • Feeling anxious
  • Nausea
  • Increased blood pressure
  • Numbness
  • Spinning sensation
  • Feeling drunk
  • Dizziness
  • Feeling happy or excited
  • Lack of energy
  • Vomiting

These side effects may typically be present for the first 40 minutes after taking the nasal spray of ketamine. If such side effects occur, they typically disappear the same day.

We accept most insurances and will work with your insurance company to cover this service. Some or all of our charges for this treatment may be covered by your insurance. 

Please call your insurance company and ask if treatment with Spravato (esketamine) is covered.

The manufacturer of Spravato (Janssen) also provides assistance for patients in determining insurance coverage and may be able to provide some financial support for your treatment as well.

Please call the Janssen CarePath Program at 844-777-2828.

This is prohibited by the FDA, as ketamine has the potential to be abused, and can therefore lead to addiction. Therefore, its administration must solely be at the doctor’s office.